Hypertension Blood Pressure Research Articles

Hypertension guideline implementation and blood pressure control in Matlosana, South Africa.

High systolic blood pressure remains a leading modifiable risk factor for cardiovascular diseases worldwide and in South Africa (SA). Information about the extent of guideline implementation and blood pressure (BP) control is lacking in Matlosana Sub-district, North West province, SA. The study aimed to assess the implementation of the South African Hypertension Practice Guideline (SAHPG) and BP control in adults attending primary care facilities in Matlosana. Cross-sectional study was conducted, using 523 randomly sampled medical records. Data collected included demographic information, recorded BP readings, anthropometry, screening for target organ damage (TOD), hypertension complications, comorbidities, lifestyle advice and drug therapy. According to the reviewed records the mean age of the participants was 56.77 years with a standard deviation of 12.4 years and 376 (71.9%) records belonged to females. Blood pressure control was documented in 229 (43.8%) of the medical records, with better control recorded in a group with comorbid human immunodeficiency virus (HIV) than in groups with other comorbidities. The study found poor documentation of the SAHPG recommendations among patients with hypertension. According to the patient records BP control was suboptimal, the most common documented comorbid illness was HIV, and screening for TOD was generally poorly documented.Contribution:Programmes that audit and improve the quality of hypertension guideline implementation and BP control in primary care require ongoing support and research.

Social determinants of health, blood pressure classification, and incident stroke in community-dwelling adults: a prospective cohort study

Abstract Objective To determine whether the association of blood pressure (BP) categories, defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline, with stroke differ among Chinese adults with low or high burden of unfavorable social determinants of health (SDOH). Design and Methods: Analyses were conducted in the prospective sub-cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, started in 1, July 2017 and followed stroke events until 31, June 2023. Participants were divided into groups with low and high burden of unfavorable SDOH, which consisted of educational attainment, economic stability, health care access, social support, and neighborhood relationship. Within each group, participants were categorized as having normal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg), elevated BP (SBP 120-129 mm Hg and DBP <80 mm Hg), stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg), and stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90mm Hg). The association between BP categories and stroke risk were examined within each SDOH group, separately, using multivariable-adjusted Cox proportional hazards models. Results Of the 96,686 adults included in this study (mean [SD] age, 53.8 [10.1] years; 59,080 [61.1%] women), 64,823 (67.0%) were categorized as having high burden of unfavorable SDOH. Over a median follow-up of 5.0 years, 4,673 (4.8%) incident stroke events occurred. In the group of low burden of SDOH, hazard ratios (95% CI) for stroke events for elevated BP, stage 1 hypertension, and stage 2 hypertension vs normal BP were 1.09 (0.86-1.37), 1.14 (0.94-1.37), and 1.59 (1.33-1.90), respectively. In the group of high burden of SDOH, hazard ratios for stroke events for elevated BP, stage 1 hypertension, and stage 2 hypertension vs normal BP were 1.20 (1.04-1.38), 1.45 (1.29-1.62), and 1.71 (1.53-1.91), respectively. Results were similar after excluding those taking antihypertensive medications. Conclusion Lower BP categories were closely associated with increased risk of stroke in the context of high burden of SDOH. Early counseling and surveillance of high BP should be emphasized within socioeconomically disadvantaged populations.

Risk Scores for Five Early Life Domains and Odds of Obesity and Hypertension Comorbidity

Abstract Background For outcomes such as obesity and hypertension, determinants are likely to be complex and multidimensional. Therefore, to design realistic interventions, epidemiological research should incorporate information from multiple risk exposure domains to assess the effect on health. In this paper we explore risk scores for five early life domains and odds of obesity and hypertension comorbidity. Methods We used data from 17,196 participants in the 1970 British Cohort Study. The outcome was obesity (BMI of ≥ 30) and hypertension (blood pressure>140/90mm Hg or self-reported doctor’s diagnosis) comorbidity at age 46. Early life domains included: ‘prenatal, antenatal, neonatal and birth’, ‘developmental attributes and behaviour’, ‘child education and academic ability’, ‘socioeconomic factors’ and ‘parental and family environment’. Stepwise backward elimination selected variables for inclusion for each domain. Predicted risk scores of obesity and hypertension for each cohort member within each domain were calculated. Logistic regression investigated the association between domain-specific risk scores and odds of obesity-hypertension, controlling for demographic factors and other domains. Results In unadjusted models, higher domain-specific risk scores were associated with increased odds of obesity-hypertension comorbidity. In adjusted analyses, higher domain-specific risk scores remained associated with increased odds of obesity-hypertension comorbidity, with the strongest associations to the parental and family environment domain (OR1.11 95%CI 1.05-1.18) and the socioeconomic factors domain (OR1.11 95%CI 1.05-1.17). Conclusions Appropriate modelling choices of combined effects of early-life risk factors need to be explored and tested. Targeted prevention interventions aimed at population groups with shared early-life characteristics could have an impact on cardiovascular risk in adulthood. Key messages • Targeted prevention interventions aimed at population groups with shared early-life characteristics could have an impact on obesity-hypertension prevalence. • Appropriate modelling choices of combined effects of early-life risk factors need to be explored and tested.

Trends in prevalence of hypertension and high-normal blood pressure among US adults, 1999–2018

Hypertension and high-normal blood pressure (BP) increase the risk for cardiovascular diseases. Examining trends in hypertension and high-normal BP among US adults is crucial. Participants aged 20 years or older from the 1999–2018 National Health and Nutrition Examination Surveys, were included. Trend analyses were performed to assess temporal changes in prevalence of hypertension and high-normal BP among US adults. Among the 48,580 participants included in this analysis, the mean (SD) age was 47.2 years (18 years) and 50.9% were women. Age-adjusted prevalence of hypertension was stable from 1999 to 2000 (29.5% [95% CI 26.6–32.3%]) through 2017–2018 (31.9%, [95% CI 29.0–34.7%]) (P = 0.265 for linear trend). Age-adjusted prevalence of high-normal BP decreased from 10.9% (95% CI 9.4–12.5%) in 1999–2000 to 8.0% (95% CI 7.1–9.0%) in 2007–2008, then increased to 9.8% (95% CI 8.3–11.3%) in 2017–2018 (P = 0.002 for nonlinear trend). Compared with men, hypertension and high-normal BP was less likely among women (multivariable-adjusted prevalence ratio, 0.90 [95% CI 0.84–0.97]; 0.68 [95% CI 0.52–0.88], respectively). Compared with non-Hispanic Black, high-normal BP was less likely among Mexican American, non-Hispanic White, and other race (multivariable-adjusted prevalence ratio, 0.59 [95% CI 0.44–0.79]; 0.53 [95% CI 0.41–0.69]; 0.56 [95% CI 0.74 − 0.71], respectively). The same held for hypertension.

C-reactive protein improves the ability to detect hypertension and insulin resistance in mild-to-moderate obstructive sleep apnea: Age effect.

C-reactive protein (CRP) appears to improve the ability to detect cardiometabolic risk in young and middle-aged adults with mild-to-moderate obstructive sleep apnea (mmOSA). The aim of this study is to assess utility of CRP in identifying the risk of hypertension and insulin resistance across a wide age range including older patients with mmOSA. Adults (n = 216) of a wide age range (28-90 years old, mean age 52.64 ± 12.74) with mmOSA (5 ≤ AHI < 30) completed in-lab polysomnography or home sleep apnea testing, physical examination including blood pressure (BP) measures, structured medical history questionnaire, and blood draw for CRP and fasting glucose and insulin levels. In adults < 60 years, lnCRP but not the apnea-hypopnea index (AHI) was associated with greater odds for hypertension (odds ratio [OR] = 2.40, 95% CI = 1.20-4.84, p = 0.01; OR = 1.00, 95% CI = 0.92-1.08, p = 0.92, respectively) and with higher average systolic and diastolic BP. Also, in adults < 60 years lnCRP but not AHI, was associated with higher lnHOMA values. In contrast, in adults > 60 years neither lnCRP nor AHI were associated with greater odds for hypertension, average systolic and diastolic BP, and lnHOMA. Receiver-operating characteristics curves revealed that adding CRP to standard clinical factors (age, sex, and BMI) yielded moderately good risk models for hypertension in patients < 60 years (AUC = 0.721). In conclusion, CRP improves the ability to detect cardiometabolic risk in young and middle-aged, but not older adults with mmOSA, suggesting that inflammation may be a primary pathogenetic mechanism in younger patients with OSA.

The effect of digital therapeutics intervention on improving hypertension management in adults: a meta-analysis of randomized controlled trial.

Digital therapeutics (DTx) intervention is an emerging therapy for the treatment and long-term management of hypertension. We aim to systematically evaluate the overall effect of DTx intervention on improving hypertension management. The systematic review and meta-analysis of RCTs was conducted and the PubMed, EMBASE, Web of Science, and Cochrane Library were searched to identify eligible RCTs published between Jan 1, 1982 and Sep 10, 2023. Random-effect models were utilized to pool estimates of net changes in systolic blood pressure (BP), diastolic BP, BP control rate, body mass index, weight, waist circumference, and physical activity between the DTx group and control group. 15 RCTs were included with a total of 3789 participants. Compared with the control group, DTx intervention was associated with significant changes in systolic BP, diastolic BP, and BP control rate of -3.75 mmHg(95% CI -5.74 to 1.77), -1.79 mmHg (95% CI -2.81 to -0.77) and 1.47% (95% CI 1.10 to 1.95), respectively. In addition, DTx intervention was statistically significant for improving other risk factors such as lower BMI (-0.5 kg/m2, 95% CI -0.86 to -0.15), increased physical activity (66.73 min/week, 95%CI 49.64 to 83.81), and reduced waist circumference (-2.91 cm, 95% CI -5.15 to -0.66). No difference between groups was demonstrated in weight (P = 0.30). Subgroup analyses revealed consistent effects of the change in SBP and DBP across study duration, age, sample size, patient baseline status, and intervention scenario settings(P > 0.05). DTx intervention may be useful for lowering BP and long-term management of hypertension. More large-size trials providing evidence on the same product are needed.

The Influence of Non-Dipping Pattern of Blood Pressure in Gestational Hypertension on Early Onset of Hypertension Later in Life-Single Center Experience in Very-High-Risk Southeast and Central European Country.

Gestational hypertension (GH) and preeclampsia (PE) are associated with the onset of hypertension. This study aimed to investigate whether the blood pressure (BP) pattern in GH is associated with the prevalence of hypertension later in life. In this prospective cohort study pregnant women screened for GH underwent medical history, laboratory analysis, ambulatory blood pressure monitoring (AMBP), and transthoracic echocardiography (with left ventricular global longitudinal strain (LVGLS)) assessment. Overall, 138 GH (67 non-dippers and 71 dippers), 55 preeclamptic, and 72 normotensive pregnant controls were included. Women were followed in the postpartum period, first after 6 weeks and later on, for the occurrence of hypertension. The median follow-up was 8.97 years (8.23; 9.03). Non-dippers and PE compared with normotensives and dippers had a higher prevalence of hypertension onset (p < 0.01), as well as significantly reduced absolute values of LVGLS during pregnancy, after delivery, and at the time of onset of hypertension during follow-up (p < 0.01). Night-time diastolic BP, LVGLS, age, and left ventricular ejection fraction were the strongest predictors of postpartum onset of hypertension. The non-dipping BP pattern in GH was significantly associated with the onset of hypertension later in life, as well as with decreased systolic function.

Effectiveness of Home-Based Self-monitoring of Blood Pressure in a Primary Care set-up of India (EASE-BP): Protocol for an Open-Label Randomized Controlled Trial.

Rising hypertension from inadequate detection, noncompliance with treatment, and poor control presents a major public health challenge. Previously, adopting the strategy of self-monitoring of blood pressure (SMBP) showed better hypertension detection, control, and medication adherence. However, evidence from India is scarce. Here, we present the trial protocol for the effectiveness of SMBP intervention in hypertension detection, blood pressure (BP) control, and medication adherence in a primary care set-up. EASE-BP is an open-label randomized trial in two distinct adult populations - part-A self-reported non-hypertensive population (total sample size: 400) and part-B known hypertensive population (total sample size: 332). The two populations will be sampled from two separate villages under the Ballabgarh Health and Demographic Surveillance System. In both the populations, participants randomized in the intervention arm will receive a validated electronic BP device and will be advised to self-monitor BP for at least twice a month (or more). Those in the control arm will be advised to monitor BP for at least twice a month (or more) at the nearby health center. Participants in both arms will receive education on hypertension and atherosclerotic disease. In addition, adult family members in the households of randomized participants will be encouraged to monitor their BP. All participants and family members will be instructed to maintain a log of BP recordings in a diary that will be provided to them. Data will be collected at baseline and then every month for three-months. The primary outcome in part-A will be the incidence of new cases of hypertension during 3 months follow-up and in part-B will be the difference in SBP and rate of medication adherence at 3 months follow-up. Secondary outcomes will include (1) uptake of the intervention, (2) any stroke, myocardial infarction, or death, (3) additional yield of new cases of hypertension among the family members, and (4) integrating the intervention into the national programs for long-term noncommunicable disease goals. EASE-BP will help understand if SMBP improves hypertension detection, BP control, and medication adherence. Consequently, this will appraise policymakers on whether provision of BP instruments may be added to the national program for hypertension prevention and control. This trial was registered under Clinical Trial Registry - India with reference number CTRI/2023/02/049949.

Gender-specific associations between sleep stages and cardiovascular risk factors.

Sleep characteristics are associated with cardiovascular disease (CVD) risk and both sleep and CVD risk vary by gender. Our objective was to examine associations between polysomnographic sleep characteristics and CVD risk after excluding moderate-severe sleep apnea, and whether gender modifies these associations. This was a cross-sectional study with at-home polysomnography in adults in Brazil (n= 1,102 participants with apnea-hypopnea index (AHI)<15 events/hour). Primary exposures were N3, REM, wake after sleep onset (WASO), arousal index (AI) and AHI, and outcomes were blood pressure (BP) and lipid levels. Associations between sleep and BP varied by gender. In women, more N3 was associated with lower systolic BP (-0.40 mmHg per 10 minutes, 95%CI -0.71, -0.09), lower diastolic BP (-0.29 mmHg per 10 minutes, 95%CI -0.50, -0.07), and lower odds of hypertension (OR 0.94, 95%CI 0.89, 0.98). In men, more WASO was associated with higher systolic BP (0.41 mmHg per 10 minutes, 95%CI 0.08, 0.74) and higher odds of hypertension (OR 1.07, 95%CI 1.01, 1.14). No interactions by gender were observed for lipids. More WASO was associated with lower total cholesterol (-0.71 per 10 minutes, 95%CI -1.37, -0.05). Higher AHI was associated with higher total cholesterol (+0.97 per event/hour, 95%CI 0.24, 1.70) and higher LDL (+0.84 per event/hour, 95%CI 0.04, 1.64). N3 is more strongly associated with BP in women, which is consistent with other studies demonstrating gender differences in BP control and CVD risk and adds a novel risk factor. Longitudinal and interventional studies are required to determine whether changes in N3 result in BP changes.

Human iPSC-derived mesenchymal stem cells relieve high blood pressure in spontaneously hypertensive rats via splenic nerve activated choline acetyltransferase-positive cells.

Despite substantial advancements in modern medicine, the management of hypertension remains a major challenge. Stem cell-based therapies have recently demonstrated remarkable efficacy in treating cardiovascular diseases, including hypertension. However, the antihypertensive mechanism of mesenchymal stem cells (MSCs) has not been extensively explored. This study aimed to investigate the role of injected MSCs in regulating blood pressure homeostasis. Our previous study demonstrated that human induced pluripotent stem cell-derived mesenchymal stem cells (hiPSC-MSCs) are functional and homogeneous sources for MSC-based therapy. After the injection of hiPSC-MSCs, a significant reduction in blood pressure and end target organ inflammation were observed in spontaneously hypertensive rats (SHRs). Cell tracking assays demonstrated that the injected hiPSC-MSCs accumulated in the spleens of the SHRs. The injected hiPSC-MSCs accumulated adjacent to the splenic nerve, potentially contributing to the antihypertensive effects. Furthermore, the hiPSC-MSCs released abundant glutamate, which acts as a neuromodulator to activate the splenic sympathetic nerve. After inhibition of glutamate synthesis by siRNA, the ability of hiPSC-MSCs to activate sympathetic nerves was significantly diminished. In addition, the antihypertensive effects of hiPSC-MSCs were eliminated after splenic nerve denervation (SND), underscoring the critical role of the splenic nerve. Moreover, activation of the splenic nerve resulted in increased release of norepinephrine (NE), which increased the number of choline acetyltransferase-positive (ChAT+) cells in the spleen and peripheral blood. Consequently, the acetylcholine (ACh) produced by elevated ChAT+ cells could act as a vasodilator, lowering blood pressure and mitigating inflammation in end target organs. In summary, our findings indicate that hiPSC-MSCs effectively lower blood pressure in hypertension by influencing the splenic nerves and regulating ChAT+ cells. The connection between blood pressure regulation and the splenic nerve may offer new insights into the treatment of hypertension.

Relationship Between Sodium Intake, Physical Activity and Stress with the Incidence of Hypertension in Pregnant Women at the Gununghalu Health Center 2023

Hypertension or high blood pressure refers to a condition where blood pressure in the blood vessel system continues to increase (World Health Organization, 2018). Gestational hypertension can have detrimental effects on the mother and fetus, and increase the risk of cardiovascular disease in the future. Women who have experienced preeclampsia or hypertension have higher health risks, including a 7- to 8-fold increased risk of death from coronary artery disease (Subki &amp; et al, 2018). This study aims to investigate the correlation between factors that influence the incidence of hypertension in pregnant women in the area served by the Gununghalu Community Health Center. The research design used was case control, with a population of 1,473 people, where the sample consisted of pregnant women, including 63 of whom had hypertension. Data analysis was carried out using the Chi-Square method and multiple logistic regression analysis to identify factors that influence the incidence of hypertension. The research results show that there is a relationship between sodium consumption and hypertension in pregnant women showing a significance value of 0.007, indicating that there is a significant correlation between stress and the incidence of hypertension in pregnant women with a p value of 0.028. However, no significant relationship was found between physical activity and the incidence of hypertension in pregnant women, with a p value of 0.084. Multivariate analysis shows that sodium consumption is a risk factor for hypertension in pregnant women (p=0.004). It is hoped that all pregnant women will always have a pregnancy check-up with a health worker to avoid risks during pregnancy.

HUBUNGAN ANTARA DERAJAT HIPERTENSI DENGAN KUALITAS TIDUR PADA PASIEN HIPERTENSI DI RUMAH SAKIT PMI KOTA BOGOR

Background: According to the Ministry of Health (2021), Hypertension or high blood pressure is characterized by an increase in systolic blood pressure exceeding 140 mmHg and diastolic blood pressure exceeding 90 mmHg in two measurements taken five minutes apart in a sufficiently rested/quiet state. Poor sleep quality occurs due to increased cortisol hormone, caused by the activation of the sympathetic nervous system, which enhances vasoconstrictor effects (epinephrine and norepinephrine) that influence the increase in blood pressure. Individuals with good sleep quality tend to experience a better quality of life. This study aims to determine the relationship between the degree of hypertension and sleep quality in hypertensive patients at PMI Hospital Bogor City in 2023. Method: This is a quantitative study with a cross-sectional analytical study design. The sampling technique used in this study is non-probability sampling with a sample size of 82 individuals using accidental sampling. Sleep quality was measured using the PSQI questionnaire. Data analysis employed univariate and bivariate analyses with the chi-square statistical test. Results: The Chi-square test analysis for the relationship between the degree of hypertension and sleep quality in hypertensive patients yielded a p-value of 0.115 (p &gt; 0.05). Conclusion: Based on the results of this research, it is concluded that there is no significant relationship between the degree of hypertension and sleep quality in hypertensive patients at PMI Hospital Bogor City in 2023. Keywords: Hypertension Severity; Sleep Quality; PSQI

Hypertensive Blood Pressure in Adolescent Females with Polycystic Ovary Syndrome: Adolescent PCOS and hypertensive blood pressure

INTRODUCTIONPolycystic ovary syndrome (PCOS) is associated with hypertension in women, but few population studies have examined findings among adolescents. This retrospective study examines PCOS and hypertensive blood pressure (BP) in a large adolescent population receiving routine healthcare. METHODSAmong females aged 13-17 years who had a well-child visit with systolic/diastolic BP measured in a Northern California healthcare system (2013-2019), the outcome of hypertensive BP (≥130/80 mmHg) was examined. PCOS was based on clinical diagnosis (ICD-9/10 256.4/E28.2) within one year of the visit. Overweight and obesity were defined by body mass index 85th to <95th percentile and ≥95th percentile, respectively; 1.7% with underweight (<5th percentile) were excluded. Multivariable logistic regression was used to examine the association of PCOS and hypertensive BP, adjusting for age, race/ethnicity, BMI category, and estimated neighborhood deprivation index. Analyses were conducted in 2023-2024. RESULTSThe cohort included 224,418 females (mean age 14.9±1.4 years; 34.3% non-Hispanic White, 30.1% Hispanic, 19.5% Asian/Pacific Islander, and 9.7% Black. Overall, 18.7% had overweight and 15.8% had obesity. The prevalence of hypertensive BP was 7.2%, much higher for those with PCOS (18.2%) versus no PCOS (7.1%, p<0.001). In adjusted analyses, PCOS was associated with 1.25-fold greater odds of hypertensive BP [95% confidence interval 1.10-1.42]). Similar findings were seen among the subset with obesity (odds ratio 1.23 [1.06-1.42]). CONCLUSIONSNearly 1 in 5 adolescents with PCOS had hypertensive BP. PCOS was associated with 25% increased adjusted odds of hypertensive BP, emphasizing the importance of BP surveillance in this population with higher cardiometabolic risk.

Association of hypertension and long-term blood pressure changes with new-onset diabetes in the elderly: A 10-year cohort study.

To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China. A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression. By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005). Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.

The Effect of Mocaf Flour and Yellow Pumpkin Flour (Cucurbita Moschata) Proportion on the Acceptability and Physicochemical Quality of Wet MI

Overcoming dependence on wheat flour as raw material, researchers want to develop a wet noodle product by using mocaf flour to substitute wheat flour and adding pumpkin flour to increase the nutritional value of wet noodles, namely potassium minerals as an alternative main food that can help lower blood pressure in hypertension sufferers.To determine the effect of the proportion of mocaf flour and pumpkin flour on the physicochemical quality of wet noodles. This type of research uses an experimental study design with a Completely Randomized Design (CRD). The comparison of the proportions of mocaf flour and pumpkin flour is P0 (100g : 0g), P1 (95g : 5g), P2 (90g :10g), P3 (85 g :15g), P4 (80g :20g). Physical quality and chemical quality test data were analyzed using the Independent T-test. The research results show that the percent water absorption capacity; percent elongation; potassium levels; and sodium levels, namely P0 (58.5% ; 19.8% ; 16.5mg/100 g; 5.64 mg/100g), P2 (70.3% ; 8.8% ; 55.95 mg/100g ; 5.55 mg/100g). The best treatment P2 does not meet the adult RDA percentage and cannot be classified as high in potassium. Wet noodle products cannot yet be used as an alternative to foods high in potassium for preventing hypertension.

DESCRIPTIVE STUDY OF BLOOD PRESSURE BASED ON PHYSICAL ACTIVITY AND FAST FOOD EATING BEHAVIOR IN SECOND YEAR FEMALE STUDENTS OF THE HEALTH FACULTY OF MUHAMMADIYAH UNIVERSITY OF GRESIK

The objective of this study is to determine the blood pressure based on physical activity and fast food eating behavior among female students level II at the Faculty of Health, Universitas Muhammadiyah Gresik. This research was conducted through quantitative descriptive observational methods in March and July 2023. The subjects in this research were level II female students who were selected using a cluster random sampling technique. The results of this study show that (1) the frequency of eating fast food for pre-hypertension and normal blood pressure is mostly rare, namely 90.9% and 68.8%. (2) Most types of fast food eating at normal blood pressure and pre-hypertension are in the high sugar category, namely 68.8% and 84.5%. (3) The energy intake of those with normal blood pressure was mostly normal (27.3%), the energy intake of those with pre- hypertensive blood pressure was mostly a severe deficit and normal (36.4%). (4) Protein intake for those with normal blood pressure is mostly excessive (32.5%). Protein intake for those with pre-hypertensive blood pressure is mostly a severe deficit (36.4%) (5) Fat intake for those with normal blood pressure is mostly excessive (44.2%), fat intake for those with pre-hypertensive blood pressure is mostly severe and mild deficits (36.4%). (6) Carbohydrate intake for those with normal blood pressure was mostly normal (39.0%), carbohydrate intake for those with pre-hypertensive blood pressure was mostly normal (36.4%).

Overview of Medication Administration to Hypertension Patients at Harapan Raya Community Health Center

Hypertension or high blood pressure is an increase in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg in two measurements with an interval of five minutes in a state of sufficient rest/calm. This research is a descriptive observational study. The research was conducted at Harapan Raya Community Health Center in April 2024. The sample in this study was hypertension patients who received treatment at Harapan Raya Community Health Center in March 2024. The instrument used in this research was secondary data from the monthly report of Harapan Raya Community Health Center in March 2024. The data used obtained and then analyzed by calculating the percentage of drug use. Based on the results at the Harapan Raya Community Health Center, it can be concluded that: Patients who consume a lot of hypertension medication are female with 75 respondents and 39 male respondents. The highest number of patients who took hypertension medication were in the elderly age range, with 68 respondents, 44 respondents for middle adults, and 2 respondents for early adults. The drug that is often used in community health centers is amlodipine 10 mg.

The Role of Exercise Blood Pressure in Hypertension: Measurement, Mechanisms and Management.

Hypertension affects one in three adults globally and is the leading modifiable risk factor for cardiovascular disease. While blood pressure measurements at rest are fundamental to the detection and management of hypertension, abnormal blood pressure responses to exercise, namely an exaggerated exercise blood pressure (EEBP), can provide additional independent information about current and future hypertension risk. This paper summarizes a symposium entitled: "The Role of Exercise BP in Hypertension: Measurement, Mechanisms and Management" included at the 2023 American College of Sports Medicine annual meeting, which presented a timely discussion about the clinical utility of EEBP. Here we will summarize the evidence presented by the speakers including considerations for blood pressure measurement during exercise, an overview of EEBP thresholds and discussion about the value of EEBP during submaximal exercise for the identification and management of hypertension, a summary of the potential physiological mechanisms underpinning an EEBP, and a review of exercise prescription guidelines based on new and emerging evidence as they relate to the American College of Sports Medicine's exercise recommendations for hypertension. We conclude by highlighting areas for future research with the overarching goal of improving the measurement and management of hypertension.

Cardiovascular dysautonomia and cognitive impairment in Parkinson's disease (Review).

Cognitive impairment is a prevalent non-motor symptom of Parkinson's disease (PD), which can result in significant disability and distress for patients and caregivers. There is a marked variation in the timing, characteristics and rate at which cognitive decline occurs in patients with PD. This decline can vary from normal cognition to mild cognitive impairment and dementia. Cognitive impairment is associated with several pathophysiological mechanisms, including the accumulation of β-amyloid and tau in the brain, oxidative stress and neuroinflammation. Cardiovascular autonomic dysfunctions are commonly observed in patients with PD. These dysfunctions play a role in the progression of cognitive impairment, the incidents of falls and even in mortality. The majority of symptoms of dysautonomia arise from changes in the peripheral autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. Cardiovascular changes, including orthostatic hypotension, supine hypertension and abnormal nocturnal blood pressure (BP), can occur in both the early and advanced stages of PD. These changes tend to increase as the disease advances. The present review aimed to describe the cognitive changes in the setting of cardiovascular dysautonomia and to discuss strategies through which these changes can be modified and managed. It is a multifactorial process usually involving decreased blood flow to the brain, resulting in the development of cerebral ischemic lesions, an increased presence of abnormal white matter signals in the brain, and a potential influence on the process of neurodegeneration in PD. Another possible explanation is this association being independent observations of PD progression. Patients with clinical symptoms of dysautonomia should undergo 24-h ambulatory BP monitoring, as they are frequently subtle and underdiagnosed.

Detection of hypertension using a target spectral camera: a prospective clinical study

Hypertension is a significant contributor to premature mortality, and the regular monitoring of blood pressure (BP) enables the early detection of hypertension and cardiovascular disease. There is an urgent need for the development of highly accurate cuffless BP devices. We examined BP measurements based on a target spectral camera’s recordings and evaluated their accuracy. Images of 215 adults’ palms and faces were recorded, and BP was measured. The camera captured RGB wavelength data at 640 × 480 pixels and 150 frames per second (fps). These recordings were analyzed to extract pulse transit time (PTT) values between the face and palm, a key parameter for estimating BP. Continuous BP measurements were taken using a CNAPmonitor500 for validation. Three frequency wavelengths were measured from video images. A machine learning model was constructed to determine hypertension, defined as a systolic BP of 130 mmHg or higher or a diastolic BP of 80 mmHg or higher, using the visualized data. The discrimination between hypertension and normal BP was 95.0% accurate within 30 s and 90.3% within 5 s, based on the captured images. The results of heartbeat-by-heartbeat analyses can be used to determine hypertension based on only one second of camera footage or one heartbeat. The data extracted from a video recorded by a target spectral camera enabled accurate hypertension diagnoses, suggesting the potential for simplified BP monitoring.