Increase In Blood Pressure Research Articles

Comparison of High and Low Dose Calcium Supplementation in Prevention of Hypertensive Disorders of Pregnancy

Calcium supplementation during pregnancy may prevent high blood pressure and preterm labour. Out of 500 women, 480 completed the study. At hospital enrolment, the average systolic blood pressure (SBP) was similar between the two groups (116.10 mm Hg vs. 115.01 mm Hg; P = 0.215), as was the average diastolic blood pressure (DBP) (72.74 mm Hg vs. 72.12 mm Hg; P = 0.301). No significant increase in blood pressure was observed in the majority of pregnant women in either group until delivery. Only 2.5% of women in the low-dose group (LDG - group I) and 1.88% in the high-dose group (HDG - group II) developed pre-eclampsia by the end of the study, with no significant association between different calcium dosages and the occurrence of pre-eclampsia (P = 0.503). Regarding maternal complications, 0.63% of women in the group I and 0.21% in the group II experienced major complications during pregnancy or postpartum, but this was not statistically significant (P = 0.623). Among the 480 women, 475 had term labor, and only 5 had preterm deliveries (before 36 weeks of gestation). No maternal deaths were reported.Our study concluded that calcium supplementation, whether in low or high dose, provides significant benefit for pregnant women. The findings demonstrate a notable advantage in preventing pregnancy-induced hypertension (PIH), preterm labor, premature births, and related complications. Therefore, calcium supplementation is highly effective in preventing PIH, which in turn helps prevent pre-eclampsia and eclampsia. As both low and high dose Calcium are effective in preventing PE and Eclampsia, it may be recommended that low dose calcium supplementation may be helpful in prevention of HDP and have favourable feto-maternal outcome in a low resource setting like ours. Keywords: Hypertensive disorders of pregnancy (HDP), Blood Pressure, Pre-eclampsia, Calcium.

Response of the nephron arterial network and its interactions to acute hypertension: a simulation.

We simulated the dynamics of a group of 10 nephrons supplied from an arterial network and subjected to acute increases in blood pressure. Arterial lengths and topology were based on measurements of a vascular cast. The model builds on a previous version exercised at a single blood pressure with 2 additional features: pressure diuresis and the effect of blood pressure on efferent arteriolar vascular resistance. The new version simulates autoregulation, and reproduces tubule pressure oscillations. Individual nephron dynamics depended on mean arterial pressure and the axial pressure gradient required to cause blood flow through the arteries. Rhythmic blood withdrawal into afferent arterioles caused blood flow fluctuations in downstream vessels. Blood pressure dependent changes in nephron dynamics affected synchronization metrics. The combination of vascular pressure gradients and oscillations created a range of arterial pressures at the origins of the 10 afferent arterioles. Because arterial blood pressure in conscious animals has 1/f dynamics, we applied an arterial pressure pattern with such dynamics to the model. Amplitude of tubule pressure oscillations were affected by the 1/f blood pressure fluctuations, but the oscillation frequencies did not change. The pressure gradients required to deliver blood to all afferent arterioles impose a complexity that affects nephrons according to their locations in the network, but other interactions compensate to ensure the stability of the system. The sensitivity of nephron response to location on the network, and the constancy of the tubular oscillation frequency provide a spatial and time context.

Epithelial Na+ Channels, Immune Cells, and Salt.

Epithelial Na+ channels (ENaCs) are known to affect blood pressure through their role in transporting Na+ in the distal nephron of the kidney. While expressed in other epithelial tissues, there is growing evidence that ENaCs are also expressed in nonepithelial tissues where their activity influences blood pressure. This review provides an overview of ENaCs and key mechanisms that regulate channel activity. The role of ENaCs in antigen-presenting dendritic cells is discussed, where ENaC-dependent sensing of increases in the extracellular Na+ concentration leads to activation of a signaling cascade, T cell activation with the release of proinflammatory cytokines, and an increase in blood pressure. The potential contribution of this pathway to human hypertension is discussed.

Short- and Long-Term Effects of Inhaled Ultrafine Particles on Blood Pressure: A Systematic Review and Meta-Analysis

Background: Air pollution contributes to up to 60% of premature mortality worldwide by worsening cardiovascular conditions. Ultrafine particles (UFPs) may negatively affect cardiovascular outcomes, and epidemiological studies have linked them to short- and long-term blood pressure (BP) imbalance. Methods: We conducted a systematic review and meta-analysis of the short- and long-term effects of UFP exposure on systolic (SBP) and diastolic (DBP) blood pressure. Eligibility criteria were established using the Population, Exposure, Comparator, Outcome, and Study Design (PECOS) model, and literature searches were conducted in Web of Science, PubMed, Embase, and Scopus for studies published between 1 January 2013 and 9 October 2024. Risk of Bias (RoB) was assessed following World Health Organization (WHO) instructions. Separate meta-analyses were performed for the short- and long-term effects of UFP exposure on SBP and DBP. Additionally, we analyzed SBP and DBP imbalances across different timespans following short-term exposure. Results: The results showed an increase in BP during short-term UFP exposure, which returned to baseline values after a few hours. Changes in SBP were greater than in DBP following both short- and long-term exposure. Prolonged exposure to UFPs is associated with increased SBP and concurrently low DBP values. Chronic exposure to UFPs may lead to a persistent increase in SBP, even without a concurrent increase in DBP. Conclusions: The findings presented here highlight that UFPs may contribute to worsening cardiovascular outcomes in vulnerable populations living in air-polluted areas.

Heat-sensitive moxibustion combined with medication for orthostatic hypotension of yang-qi deficiency in the elderly: a randomized controlled trial

To observe the effect of heat-sensitive moxibustion combined with medication on orthostatic hypotension (OH) of yang -qi deficiency in the elderly. Sixty elderly patients with OH of yang -qi deficiency were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases). The patients in the control group were treated with oral midodrine hydrochloride tablets, 2.5 mg each time and twice daily, while the patients in the observation group were treated with heat-sensitive moxibustion in addition to the treatment in the control group. Acupoints selected included Dazhui (GV 14), Fengfu (GV 16), and Baihui (GV 20), with each session lasting 30-40 min, once daily. Both groups were treated for 4 weeks. Blood pressure in the supine and standing positions, as well as the decrease of blood pressure when the position changing from supine to standing, were measured before treatment and after 2 and 4 weeks of treatment. Clinical efficacy was also evaluated. After 4 weeks of treatment, both groups showed an increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both the supine and standing positions (P<0.05), and the decrease in SBP and DBP when the position changing from supine to standing was reduced (P<0.05). Compared with the control group, the observation group had higher SBP and DBP in both positions and a smaller decrease in SBP and DBP when the position changing from supine to standing (P<0.05). The total effective rate was 96.6% (28/29) in the observation group, which was higher than 70.0% (21/30) in the control group (P<0.05). Heat-sensitive moxibustion combined with medication could increase the blood pressure in both supine and standing position, and decrease the reducing of blood pressure when the position changing from supine to standing in elderly patients with OH of yang-qi deficiency.

THE IMPACT OF EXOGENOUS AND ENDOGENOUS FACTORS ON VASCULAR WALL ELASTICITY AND POTENTIAL CLINICAL EFFECTS (Review Article)

Vascular aging is associated with profound changes in the structural properties of the arterial wall. Arterial hypertension, diabetes mellitus, and chronic kidney disease are the primary determinants of the loss of elasticity and reduced compliance of the vascular wall. Arterial stiffness is a key parameter for assessing the elasticity of the arterial wall and can be easily evaluated using non-invasive methods such as pulse wave velocity. Early assessment of arterial stiffness is critical, as its changes may precede the clinical manifestations of cardiovascular disease. With age, arterial walls become stiffer, leading to an increase in systolic blood pressure and an increased risk of cardiovascular events such as stroke, myocardial infarction, or heart failure. The gradual decrease in vascular elasticity is accompanied by remodeling of their structure, an increase in collagen fibers, and a decrease in elastin, which exacerbates the problem. In addition, the mechanical stress on the vascular wall, which increases with age, worsens its condition, provoking the formation of atherosclerotic plaques. Arterial stiffness, as an important biomarker of vascular aging, is also an indicator of increased cardiovascular risk, independent of other factors such as blood pressure or the presence of comorbidities. Therefore, timely diagnosis of arterial stiffness can help prevent serious complications and adjust treatment for patients at risk. Important are also preventive measures, including a healthy lifestyle, physical activity, and control of the underlying diseases that contribute to the acceleration of vascular aging processes. Moreover, the influence of endogenous and exogenous factors, such as diet, the presence of chronic diseases, and bad habits (in particular, smoking), contribute to the acceleration of these processes. Innovative diagnostic methods, such as magnetic resonance imaging (MRI) or ultrasound, allow detecting these changes at early stages and, accordingly, adapting treatment.

Skeletal muscle reactive oxygen species and microvascular endothelial function in age-related hypertension: a study protocol using a microdialysis technique.

Increased reactive oxygen species (ROS) generation and microvascular endothelial disruptions occur with natural ageing, but often transpire before the detection of cardiometabolic conditions including hypertension. Age-related increases in blood pressure are driven by complex systemic changes with poorly understood integrated mechanisms. The deconditioning experienced by ageing skeletal muscle from mid-life is associated with reduced microvascular blood flow and increased peripheral resistance, suggesting that vasodilatory decrements in the muscle may precede the age-related increases in blood pressure. Structural and functional changes within the vascular and skeletal muscle systems with advancing age can influence redox homeostasis, and vice versa, further compounding microvascular endothelial dysfunction. Therefore, comparisons between the microvascular environments of healthy and hypertensive cohorts can provide insights into the changes that occur during significant periods of functional decline. This comprehensive study protocol describes a microdialysis technique to assess the interactions of microvascular health and functional changes in the muscle, which currently cannot be otherwise addressed. Here, we detail an experimental protocol to simultaneously detect skeletal muscle ROS (H2O2 and indirect O2 -), determine nutritive blood flow and assess microvascular endothelial function in response to acetylcholine stimulation. We expect that healthy middle-aged individuals should not have increased ROS generation in the muscle at rest, compared to their hypertensive or older counterparts, but may exhibit perturbed microvascular function. The described technique allows for intricate exploration of microvascular physiology that will provide a critically novel insight into benchmarking potential age-related mechanisms involved in the development of age-related hypertension, and aid in early identification and prevention. KEY POINTS: Increased reactive oxygen species (ROS) production and microvascular endothelial dysfunction precede the onset of age-related cardiometabolic and vascular conditions such as hypertension. The profound structural and functional changes that occur within the vasculature and in skeletal muscle from middle age prompt a need to mechanistically explore the microvascular environment in healthy and hypertensive individuals. Using a novel microdialysis technique, we detail an experimental protocol to simultaneously detect skeletal muscle ROS (H2O2 and indirect O2 -), determine nutritive blood flow and assess microvascular endothelial function in response to acetylcholine stimulation. With this technique and study protocol, we can reveal functional insights into potential perturbations in ROS generation at rest and the microvascular endothelium, which play important roles in the development of age-related hypertension.

The impact of different forms of exercise on intraocular pressure, blood flow, and the risk for primary open angle glaucoma.

Primary open angle glaucoma (POAG) is a chronic disease characterized by progressive optic nerve damage and irreversible loss of vision, often diagnosed at late stages. Elevated intraocular pressure (IOP) is the major risk factor for its onset and progression while older age, myopia, genetic factors, blood pressure (BP), and reduced ocular blood flow (OBF) have also been linked to the disease. Different forms of exercise are known to have significant, but variable, effects on IOP, BP, ocular perfusion pressure (OPP), OBF and oxygen metabolism, and ultimately the risk for development and progression of POAG. While population-based studies lack agreement regarding the relationship between exercise and POAG status, data suggests that resistance training causes a short-term increase in IOP, BP, and OPP. Conversely, aerobic exercise has been shown to cause a short-term decrease in IOP and increase in BP and OPP. Research also suggests that following an exercise program over an extended period may lead to a long-term decrease in IOP, however its cessation results in a prompt return to baseline levels. Data suggests normal vascular autoregulation ensures minimal change in OBF following extended exercise unless OPP rises ∼70% above baseline. Although exercise may alter IOP, BP, and OBF, both acutely and chronically, it is currently uncertain if physical activity significantly alters risk for the onset and progression of POAG.

Clinical significance of post-COVID-19 in patients with hypertension, taking into account the polymorphism of genes encoding components of the renin-angiotensin system

To date, there has been no consensus on the impact of polymorphism of components of the renin-angiotensin-aldosterone system (RAAS) on the course of a new coronavirus infection or a possible role in post-COVID syndrome. The objective is to study the significance of COVID-19 and gene polymorphism encoding components of renin angiotensin system in patients with hypertension. Materials and methods: A clinical examination was conducted on 116 stage 2 hypertensive patients with uncontrolled hypertension. Of these, 96 underwent mild or moderate COVID-19, 51 before 12 weeks and 45 after 12. Results. Patients in the ongoing symptomatic phase of COVID- 19 had higher systolic blood pressure than those with post COVID syndrome (p1-2 = 0.03659, p1-3 ≤ 0,00001).The association of polymorphisms of genes AGT:704T&gt;C, AGT521C&gt;T, AGTR1:1166A&gt;C, AGTR2:1675G&gt;A, CYP1IB2:-344C&gt;T with gender, BMI and COVID-19 transmission has not been identified. In the symptomatic phase of COVID-19, carriage of the TT genotype for the AGT704 gene was less frequent (p=0.005) compared to the control group. Conclusions. The effect of COVID on an increase in blood pressure in stage 2 hypertensive patients was determined. An association between blood pressure instability and BMI after COVID was established. During the symptomatic COVID phase, there was an association between increased blood pressure and the C allele of AGT gene polymorphisms (T704).

Comparative Evaluation of Dexmedetomidine and Clonidine on Propofol Consumption, Haemodynamics and Postoperative Recovery in Laparoscopic Surgeries: A Prospective, Double-Blind, Placebo-Controlled, Randomised Study

Background and Aims: Laparoscopic surgery is associated with significant haemodynamic changes due to pneumoperitoneum formation. Various studies have demonstrated that α2 adrenergic agonists, such as clonidine and dexmedetomidine, prevent the haemodynamic response due to pneumoperitoneum during laparoscopic surgery. Methods: A total of 104 female patients undergoing laparoscopic hysterectomies were divided into three groups at random. Group D patients were administered a loading dose of 1 μg/kg of dexmedetomidine prior to induction over a period of 15 minutes and a maintenance dose of 0.5 μg/kg/h during the surgical procedure. Group CL patients were given a loading dose of 2 μg/kg of clonidine before induction over a period of 15 minutes and a maintenance dose of 1 μg/kg/h during the surgery. Group C received same volume of normal saline over same duration and maintenance infusion throughout the surgery. The primary outcome was the haemodynamic changes at different time interval. The secondary outcome was the response to verbal commands, extubation time and orientation time. Results: There was no significant difference in heart rate and blood pressure values between group D and group CL during whole study period. Whereas in group C, there was a statistically significant increase in heart rate and blood pressure after intubation and during pneumoperitoneum period ( P &lt; 0.05). Extubation time and orientation time were significantly delayed in group D and group CL when compared with group C and D ( P &lt; 0.05). Conclusion: Clonidine or dexmedetomidine effectively attenuates the haemodynamic changes in patients undergoing laparoscopic hysterectomies compared to the control group.

Oscillatory blood pressure values in newborn infants: observational data over gestational ages.

Normative blood pressure (BP) values on preterm infants exist but are based on small cohorts of infants. Utilizing electronic medical records (EMR), we can explore earlier gestational ages (GA) and follow their progression to 40 weeks corrected gestational age (CGA). A retrospective cohort study of infants within the SSM Health System from 7/01/2013 through 6/30/2023. Infants born at >22 0/7 weeks but < 41 weeks GA were included if any BP measurements existed (n=29,323 infants, 1.4 million BPs). Data was extracted electronically from EMR using Microsoft SQL. Systolic BP (SBP), mean arterial pressures (MAP), and Diastolic BP (DBP) were determined for each week of life from birth and percentile ranges (1st to 99th) for infants alive at CGA, and BP patterns for GA determined. Percentiles for SBP, DBP and MAP are provided. There is a rapid increase in BP at all gestations during the first two weeks, thus BP values are higher at any CGA in infants born at an earlier GA than infants born at that GA. For MAP values between the 5th and 10th percentile, the GA is appropriate for first week then use CGA + 5 mmHg. After the first week, 2.8 X CGA is between 90 and 95 percentile for SBP. . . The BP is dependent on the gestational age at birth and the corrected gestational age when it is measured. SBP, MAP, and DBP all increase rapidly in the two weeks of life prior to a gradual increase over time.

The effect of abdominal functional electrical stimulation on blood pressure in people with high level spinal cord injury.

Single centre training study. To investigate, in a group of people with spinal cord injury (SCI), the effect of transcutaneous functional electrical stimulation of the abdominal muscles (abdominal FES) during cough training on blood pressure (BP), and how it is affected by injury characteristics and alters over time. Laboratory and community. Sixteen participants with SCI (C4-T5) underwent 25 of abdominal FES cough training (5 sets of 10 stimulated coughs) over 6 weeks as part of a previously published study on the effect of abdominal FES training on cough. Systolic BP (SBP), diastolic BP (DBP) and calculated mean arterial pressure (MAP) were measured at the completion of each set. Abdominal FES coughing resulted in an average ~30% acute increase in BP from initial resting BP across all sessions in almost all participants (p < 0.001). However, the increase in BP during abdominal FES coughs from rest reduced over the 25 sessions of training by ~35% for SBP, MAP and DBP (p = 0.024, p = 0.013 and p = 0.042, respectively). There was no meaningful change in resting BP over time (p = 0.935, p = 0.705 and p = 0.988, respectively). Overall, increases in BP during abdominal FES coughs were greatest for those with chronic injuries and cervical injuries. Transcutaneous abdominal FES during cough training acutely increases BP. However, the magnitude of the increase is reduced after 25 sessions of training. Abdominal FES may offer a solution to combat orthostatic hypotension, but its effectiveness may diminish over time.

Clinical and epidemiological characteristics of patients with pheochromocytoma and retroperitoneal paraganglioma

Introduction. Pheochromocytoma/paraganglioma (PPGL) is a rare hormonally active tumor of chromaffin tissue. Delayed diagnosis of this disease can lead to severe, even fatal, complications. Surgical treatment of PPGL without the necessary preoperative preparation can cause intraoperative uncontrolled hemodynamic impairment. In addition, since 2017, PPGL has been recognized as a malignant tumor due to the presence of metastatic potential. All these factors determine the need for early diagnosis of PPGL, which is based, first of all, on knowledge of the clinical picture by specialists in various fields.Aim. To check and confirm the epidemiological characteristics of PPGL as well as the most common clinical symptoms in the whole group of PPGL and in subgroups of clinical forms; to form a risk group for screening for PPGL.Materials and methods. There were enrolled 353 patients in the study. These patients were operated on at the St. Petersburg State University Hospital in the period from 2010 to 2022 inclusive. All the patients were verified PPGL diagnosis histologically. Clinical symptoms were assessed: a) retrospectively, by analyzing complaints and anamnesis from the initial examination in medical histories upon admission to the hospital for surgical treatment b) both in the entire group as a whole and in subgroups of clinical forms (paroxysmal, constant, mixed, asymptomatic). Statistical analysis was performed using the Python 3.11 programming language (Python Software Foundation, USA). descriptive statistics of quantitative characteristics are presented in the form of medians, first and third quartiles in me format [q1; q3], categorical features – in the form of absolute and relative frequencies in the format n (%). the frequency histogram was constructed using the Matplotlib 3.8.2 library.Results. PPGL is most common in women over 40 years of age. The most common symptoms of PPGL are the following: a feeling of rapid heartbeat (55.95%), headache (41.07%), arterial hypertension (AH) in the form of hypertensive crises (55.65%), constant increase in blood pressure (38.39%), episodes of moderate increases in blood pressure (24.11%), sweating (30.65%), general weakness and fatigue (26.19%), hot flashes or chills (24.11%). These symptoms are formed into the criteria for screening for PPGL. In the asymptomatic clinical form – lower back pain is more common (14%); with paroxysmal – panic attacks (10%); with mixed – thirst and dry mouth (10%), and with constant form – the actual constant nature of hypertension (100%).Conclusion. In a large sample of patients with a rare pathology, the most characteristic symptom complex was identified, characteristic of both PPGL and individual clinical forms. A risk group has been formed for screening for PPGL.

Optical Coherence Tomography Study of Choroidal Response to Exercise-Induced Hypertension in Chronic Central Serous Chorioretinopathy.

Background/Objectives: The aim of this study was to evaluate the choroidal vascular response using optical coherence tomography (OCT) in patients with chronic central serous chorioretinopathy (CSCR) during transient increases in blood pressure. Methods: This observational, case-control study enrolled chronic CSCR patients and age-matched healthy controls. OCT scans of the macula were performed at rest and during hand-grip (HG) isometric exercise. Mean ocular perfusion pressure (MOPP) and subfoveal choroidal thickness (SCT) were measured at baseline and during stress. Quantitative OCT assessment included the bright area (BA, stroma), dark area (DA, vascular lumen), and total choroidal area (CA). The choroidal vascularity index (CVI) was calculated as DA/CA to assess vascular response to stress. A comparative analysis between CSCR patients and controls was conducted. Conclusions: MOPP was significantly higher (p = 0.008) at baseline in CSCR patients and further increased under stress compared to controls. SCT and CA were both significantly higher in CSCR patients than in healthy subjects at rest and under stress (p < 0.001), but no change occurred after HG. A significant decrease in CVI (p = 0.005) was noted in controls under stress, but not in CSCR patients. Additionally, a negative correlation between CVI and MOPP was found in healthy subjects (-0.648; p = 0.043). The study demonstrated a choroidal vasoconstrictive response to stress in healthy subjects, as evidenced by a decrease in CVI, but not in CSCR patients. This suggests that CSCR patients may experience impaired choroidal blood flow regulation, resulting in potentially higher perfusion pressures during stress without compensatory vasoconstriction, potentially affecting the choriocapillaris.

DETERMINATION OF THE AMOUNT OF POLYPHENOLS IN THE FOOD SUPPLEMENT "ASBOSIM" USED IN THE TREATMENT OF HYPERTENSION DISEASE

It is known that one of the diseases that are difficult to treat in modern medicine is an increase in blood pressure, i.e. hypertension. Hypertension is a pathology of the cardiovascular system, a complex disease characterized by an increase in arterial pressure, followed by organomorphological changes. Hypertension is mainly caused by constant nervousness, depression and stress, increased amount of adrenaline in the blood, alcohol consumption, excessive obesity and other factors. This disease is one of the main diseases that lead to complications such as myocardial infarction, stroke, heart attacks, and heart and kidney failure. The main symptoms of high blood pressure are headache, dizziness, ringing in the ears and heart failure. High blood pressure is more common in middle-aged and elderly people.

Cardiovascular responses to experimental weight gain in humans: a feasibility study.

Obesity and hypertension share a well known association. However, the mechanisms underlying their relationship are not well understood. Our goal was to assess the feasibility of a longitudinal, interventional weight gain study with detailed cardiovascular measurements in humans. Sixteen healthy, normotensive, young, male volunteers (28 ± 7 years) were enrolled. Body composition, biochemical and cardiovascular data were obtained at baseline, and after an 8-week period of overfeeding (800-1000 kcal/day). Blood pressure (BP), cardiac output (CO) and peripheral vascular resistance (PVR) were determined, as were the minimum forearm vascular resistance (MFVR), forearm blood flow (FBF) response to mental stress and heart rate variability (HRV) parameters. Overfeeding resulted in a median weight gain of 5.6 kg [interquartile range (IQR) 4.6-6.4 kg; P < 0.001]. Seated systolic and diastolic BP were significantly increased by 10 ± 9 and 4 ± 6 mmHg, respectively, after weight gain ( P < 0.001 and P = 0.011, respectively). CO also increased and PVR decreased significantly as a result of weight gain ( P = 0.032 and P = 0.044, respectively). MFVR was also significantly decreased after weight gain ( P = 0.023). The FBF response to mental stress was blunted significantly ( P = 0.002), and sympathovagal balance and responsiveness to orthostatic challenge altered moderately after weight gain. Our overfeeding regimen resulted in moderate weight gain and significant increases in BP. An increase in CO is likely to be the dominant mechanism underlying the observed BP changes, with decreases in PVR partially compensating for these effects. Experimental weight gain, coupled with detailed cardiovascular phenotyping, is a feasible model to examine potential mechanisms underlying obesity-associated hypertension in young adults.

Safety and efficacy of catheter-directed thrombectomy without thrombolysis in acute pulmonary embolism: A systematic review and meta-analysis

BackgroundThis meta-analysis aims to investigate the safety and efficacy of catheter-directed thrombectomy (CDT) without using adjunct thrombolysis as reperfusion therapy to manage intermediate and high-risk pulmonary embolism (PE). MethodsA literature search of Ovid MEDLINE, Embase, CiNAHL, Cochrane Library, and Web of Science was conducted from inception to January 2024. Eligible studies reported more than 10 patients treated for acute PE with catheter-directed thrombectomy only, who were over 18 years of age. Primary endpoints were major bleeding, in-hospital mortality, and hemodynamic changes. ResultsEighteen studies (n = 803) were included for quantitative analysis. The pooled estimate of incidences of in-hospital mortality and major bleeding was 1.8 % (95 % CI 0.009, 0.027) and 2.1 % (95 % CI 0.011, 0.031) respectively. A pooled estimate reported a post-procedural increase in oxygen saturation and systolic blood pressure by 8.96 % (95 % CI: 3.54, 14.38) and 15.02 mmHg (95 % CI 6.35, 23.69) respectively. Post-procedural mean pulmonary artery pressure, right ventricle/left ventricle (RV/LV) ratio, and Miller score were reduced by 10.30 mmHg (95 % CI -14.94, −5.66), 0.29 (95 % CI -0.50, −0.08) and 8.09 (95 % CI -10.70, −5.47) respectively. ConclusionCDT without adjunctive thrombolysis may lead to improvements in hemodynamic outcomes and appears to exhibit favorable safety profiles. This meta-analysis provides a rationale for further research comparing CDT alone against using adjunct thrombolysis to determine optimal management strategies for intermediate to high-risk acute PE.

The Relationship Between Blood Pressure Increase and Sleep Quality of Hypertension Sufferer in Lebaksitu Village

Aims: to determine the relationship between increased blood pressure and changes in sleep quality in hypertension sufferers. Method: The study design used a correlational approach with a cross-sectional method. The number of samples was 66 respondents using a purposive sampling technique. Data collection techniques used a sleep quality questionnaire and standardized manual blood pressure measuring instrument. Data processing included editing, coding, entry and cleaning with the SPSS application to analyze univariate and bivariate. Results: this study showed that the majority of blood pressure in hypertension sufferers was in the grade I category of 45.6% with poor sleep quality of 81.8%. The results of this study also showed a significant relationship between increased blood pressure and sleep quality in hypertension sufferers with a significance value of 0.028 (&lt;0.05). Conclusion: Increased blood pressure causes headache symptoms in hypertension sufferers which disrupts the sleep cycle and worsens the quality of sleep in hypertension sufferers.

Influence between Body Mass Index and Blood Pressure With Results of Urine Protein Examination in Pregnant Women at Bangkalan Health Center

Background: Preeclampsia is an increase in blood pressure that occurs after the 20th week of gestation. Until now, the exact cause of preeclampsia is not known. During the second trimester of pregnancy the pressure in the renal veins (renal venous pressure) changes and increases. Increased renal venous pressure causes proteinuria, especially in the orthostatic position, which causes a slightly greater change in kidney size. Purpose: The aim of this study was The Relationship Between Body Mass Index And Blood Pressure With Results Of Urine Protein Examination In Pregnant Women At Bangkalan Health Center. Methods: Analytical Research Design with a cross sectional approach. Independent variable Body Mass Index and Blood Pressure, dependent variable results of urine protein examination. The sample of this study were 210 pregnant women who carried out Integrated ANC at the Bangkalan Health Center, the sampling technique used Simple random sampling. Secondary data collection by looking at medical record data, statistical tests using Rank Spearman. Results: Based on statistical tests using Rank-Spearman, the results showed ρ value (0.024) &lt;α (0.05) indicating that there is a relationship between Body Mass Index and urine protein examination results. The results of the study ρ value (0.020) &lt;α (0.05) there is a relationship between blood pressure and the results of urine protein examination. Conclusion: Detection of proteinuria is very important in the diagnosis and treatment of hypertension in pregnancy. Proteinuria is the last symptom to appear in patients with preeclampsia.

The Relationship between Body Mass Index and Blood Pressure Control in Hypertension Patients at the Sukawati I Community Health Center, Gianyar Regency

Background: Being overweight or obese is one of the factors that cause an increase in blood pressure. The bigger a person's body, the more blood is needed to supply nutrients and oxygen to other tissues and muscles. Bali Province, especially Gianyar Regency, has a relatively high number of hypertension sufferers. The highest estimate of hypertension sufferers is in the working area of the Sukawati I Public Health Center, with a prevalence of 8.55% of the total in Gianyar Regency of 17.35%. This research aims to determine the relationship between body mass index and blood pressure control in hypertensive patients at the Sukawati I Public Health Center, Gianyar Regency. Methods: The research design used was analytic observational with a crosssectional approach. The number of research subjects, namely 83 people, was taken by consecutive sampling technique. Data analysis will be carried out univariately and bivariate using the chi-square test method with a confidence level of 95% (p &lt; 0.05). Results: The results of the univariate analysis showed that the majority of study subjects were aged 51-60 years (60.2%), were female (66.3%), most had normal BMI (66.3%), and 66.3% of subjects with hypertension were classified as have controlled blood control. Based on the results of statistical tests, a value of p = 0.003 (p &lt; 0.05) was obtained, which indicated a significant relationship between body mass index and blood pressure control in hypertensive patients at the Sukawati I Public Health Center, Gianyar Regency. Conclusion: The results of this study indicate that the increasing BMI status of hypertensive patients will tend to have uncontrolled blood pressure.