Mean Blood Pressure Values Research Articles

Targeting blood pressure for stroke prevention: current evidence and unanswered questions.

High blood pressure (BP) is the leading modifiable risk factor of stroke worldwide. Although randomized clinical trials have demonstrated the beneficial effect of BP reduction on stroke risk, there are still insufficiently explored issues concerning the optimal personalized management of BP in stroke patients in terms of thresholds to be achieved and drug classes to be prescribed. Few data are available about BP control in specific clinical contexts such as in older patients, in various stroke subtypes, or in association with co-morbidities such as diabetes. In addition, although drug trials based their conclusions on achieved mean BP values, recent findings indicate that aspects such as circadian variations of BP and BP variability should be taken into account as well. This article aims to highlight current knowledge about BP control in stroke prevention and to provide new perspectives to be addressed in future studies so as to guide clinicians in their day-to-day practice.

Newborn infant parasympathetic evaluation (NIPE) as a predictor of hemodynamic response in children younger than 2 years under general anesthesia: an observational pilot study

BackgroundIt is still unknown whether newborn infant parasympathetic evaluation (NIPE), based on heart rate variability (HRV) as a reflection of parasympathetic nerve tone, can predict the hemodynamic response to a nociception stimulus in children less than 2 years old.MethodsFifty-five children undergoing elective surgery were analyzed in this prospective observational study. Noninvasive mean blood pressure (MBP), heart rate (HR) and NIPE values were recorded just before and 1 min after general anesthesia with endotracheal intubation as well as skin incision. The predictive performance of NIPE was evaluated by receiver-operating characteristic (ROC) curve analysis. A significant hemodynamic response was defined by a > 20% increase in HR and/or MBP.ResultsEndotracheal intubation and skin incision caused HR increases of 22.2% (95% confidence interval [CI] 17.5–26.9%) and 3.8% (2.1–5.5%), MBP increases of 18.2% (12.0–24.4%) and 10.6% (7.7–13.4%), and conversely, NIPE decreases of 9.9% (5.3–14.4%) and 5.6% (2.1–9.1%), respectively (all P < 0.01 vs. pre-event value). Positive hemodynamic responses were observed in 32 patients (62.7%) during tracheal intubation and 13 patients (23.6%) during skin incision. The area under the ROC curve values for the ability of NIPE to predict positive hemodynamic responses at endotracheal intubation and skin incision were 0.65 (0.50–0.78) and 0.58 (0.44–0.71), respectively.ConclusionsNIPE reflected nociceptive events as well as anesthestic induction in children less than 2 years undergoing general anaesthetia. Nevertheless, NIPE may not serve as a sensitive and specific predictor to changes in hemodynamics.Trial registrationThis study was registered on May 3, 2018 in the Chinese Clinical Trail Registry; the registration number is (ChiCTR1800015973).

199-LB: Low Prevalence of Small-for-Gestational-Age in Women with Type 1 Diabetes and Chronic Hypertension

Objective: To evaluate delivery outcomes in women with concurrent type 1 diabetes and chronic hypertension (cHTN) treated with anti-hypertensive pharmacotherapy to target blood pressure (BP) 110-129/65-79 mmHg throughout pregnancy per ADA 2008-2016 guidelines. Research Design and Methods: We abstracted clinical data from the medical records of 752 pregnancies derived from 550 women seeking prenatal care at the Joslin Diabetes Center and Beth Israel Deaconess Medical Center’s Diabetes in Pregnancy Program from 2004-2017. We calculated means and percentages, used t test or ?2 test, and linear regression to compare trimester specific BP values, birth weight and prevalence of small for gestational age (SGA) in pregnancies of women with type 1 diabetes and cHTN to those with type 1 diabetes and no cHTN. Results: Type 1 diabetes and cHTN occurred in 51 (6.7%) of pregnancies and the mean BP values were 128/76 in the first trimester; 122/72 in the second trimester; 124/76 in the third trimester; 137/82 prior to delivery. BP values were significantly higher in women with type 1 diabetes and cHTN for each trimester compared to women with type 1 diabetes and no cHTN (p&amp;lt;0.001). Women with type 1 diabetes and cHTN were older (33.4 vs. 31.5 years p=0.04), had higher BMI (28.3 vs. 26.6 kg/m2 p=0.03), were more likely to have diabetic nephropathy (10.4% vs. 2%, p&amp;lt;0.001) and use insulin pumps (75.5% vs. 60%, p=0.04). There were no significant differences in gestational age at delivery and birth weight. SGA in both groups was rare, with 0 (0%) in the type 1 diabetes with cHTN group and 5 (0.9%) in the group without cHTN (p=0.54). Conclusion: SGA is rare in pregnancies complicated by type 1 diabetes and cHTN and did not differ from those without cHTN, even when BP targets of 110-129/65-79 mmHg are used. This may provide reassurance to reestablish these lower BP targets rather than the recently adopted higher targets of 120-160/80-105 mmHg followed by ACOG since 2013 and ADA since 2017. Disclosure S. Helman: None. T. James-Todd: None. F.M. Brown: None.

Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Ischaemic-Reperfused Hearts in Adult Rats with Established Chronic Kidney Disease.

Background and ObjectivesBone marrow-derived mesenchymal stem cells (BM-MSCs) are adult multipotent non-haematopoietic stem cells that have regeneration potential. The current study aimed to detect the ability of BM-MSCs to improve kidney and cardiac functions in adult rats with established chronic kidney disease.MethodsRats were divided into sham-operated control, untreated sub totally nephrectomised and treated sub totally nephrectomised groups. Body weight, kidney and cardiac tissue weights, plasma creatinine and urea levels and arterial blood pressure were measured. ECG was recorded, and an in vitro isolated heart study was performed. Results: Stem cell treatment decreased the elevated plasma creatinine and urea levels and decreased systolic, diastolic and mean arterial blood pressure values. These changes were accompanied by a decrease in glomerular hypertrophy with apparent normal renal parenchyma. Additionally, BM-MSCs shortened Q-To and Q-Tc intervals, all time to peak tension values, the half relaxation value at 30 min of reperfusion and the contraction time at 15 and 30 min of reperfusion. Moreover, stem cell treatment significantly increased the heart rate, QRS voltage, the peak tension at the 15- and 30-min reperfusion time points and the peak tension per left ventricle at the 30-min reperfusion time point compared to the pre-ischaemia baseline. BM-MSCs resolve inter muscular oedema and lead to the re-appearance of normal cardiomyocytes. This improvement occurs with the observations of BM-MSCs in renal and heart tissues.ConclusionsBM-MSCs can attenuate chronic kidney disease progression and the associated cardiac electrophysiological and inotropic dysfunction.

A normal sodium diet preserves serum sodium levels during treatment of acute decompensated heart failure: A prospective, blind and randomized trial

We tested the hypothesis that a normal sodium diet could be associated with preservation of serum sodium during treatment of acute decompensated heart failure (ADHF). Forty-four patients hospitalized for ADHF were blindly randomized by using block method to a low sodium diet (LS: 3g/day of dietary sodium chloride; n=22, 59.5±11.9 y.o., 50% males. LVEF=30.0±13.6%); and a normal sodium diet (NS: 7g/day; n=22, 56.4±10.3 y.o., 68% males; LVEF=27.8±11.7%), and both groups were submitted to fluid restriction of 1.000mL/day. At the 7th day of intervention 16 patients of LS group and 15 patients of NS group were assessed for difference in serum sodium. Both groups had equivalent decongestion, reflected by similar percent reduction of body weight (LS:-5.0±4.7% vs NS:-4.5±5.2%. p=0.41). Reduction of the N terminal fragment of type B natriuretic peptide (NT-proBNP) was significant only in the NS (-1497.0 [-18843.0-1191.0]. p=0.04). The LS group showed lower levels of serum sodium (135.4±3.5mmol/L) compared to the NS group (137.5±1.9mmol/L; p=0.04). Four cases of hyponatremia were observed only in the LS group (22%). The NS group exhibited higher mean blood pressure values (79.4±2.4mmHg vs 75.5±3.0mmHg. p=0.03), and lower heart rate (73.2±1.6 bpm vs 75.5±2.1 bpm. p=0.02). These results suggest that a normal sodium diet, when compared to a low sodium diet, is associated with similar degrees of decongestion, but with higher levels of natremia, blood pressure and lower neurohormonal activation during ADHF treatment. clinicaltrials.gov Identifier no. NCT03722069.

SUN-076 Mean Blood Pressure Values According to Patient Type and Geographic Altitude of Residence in Ten Cities of Peru

Background: High blood pressure is one of the four values used for monitoring a patient’s health condition. However, there are no reports on this parameter in relation to populations at different geographical altitudes. This study’s main objective was to determine the mean values of blood pressure according to patient characteristics and geographic altitude of residence in Peru. Methods: This was a multicenter, cross-sectional study, taken by convenience sampling. Patients lived for more than six months in cities with altitudes ranging from sea level to 5100 meters above mean sea level (mamsl). Data was categorized using 2000-m ranges and obtained from normotensive patients with hypertension (HTN) with and without treatment. P values were obtained using a multivariate analysis using Stata (Stata Corp, Texas, USA).Results: Of the 5,236 participants, 3,305(63%) were women, and the median age was 42 years. The median systolic/diastolic blood pressures (mmHg) were 110/70, 115.5/75, and 103/63, for 0-2000 mamsl, 2001-4000 mamsl, and 4001-5100 mamsl, respectively (p < 0.001). When data was adjusted according to patient characteristics, most of the differences in values were statistically significant for treated hypertensive (systolic p < 0.001; diastolic p = 0.243) and normotensive (systolic and diastolic p < 0.001), compared to untreated hypertensive patients. Conclusion: The blood pressure values varied with the altitude of residence and type of patient. Furthermore, these parameters should be taken into account as reference values by physicians working at different geographical altitudes for management of their patients.

Percutaneous transluminal angioplasty alone versus stent placement for the treatment of transplant renal artery stenosis

PurposeThe purposes of this retrospective study were to assess the efficacy of endovascular techniques for the treatment of transplant renal artery stenosis (TRAS) by analyzing technical and clinical success and to compare the results of percutaneous transluminal angioplasty (PTA) alone to those of stenting. Materials and methodsA retrospective analysis was conducted on 31 patients who underwent endovascular treatment for TRAS between January 2012 and December 2017. There were 23 men and 8 women with a mean age of 60.5±14 (SD) years (range: 24–81 years). Ten patients (10/31; 32%; 8 men, 2 women; median age, 63 years) were treated with PTA alone and 21/31 (68%; 15 men, 6 women; median age, 65 years) with metallic stent placement. Several variables including serum creatinine level, glomerular filtration rate, arterial blood pressure value, antihypertensive medication obtained before and after treatment were compared. Technical success was assessed for each procedure. Clinical success was defined as a 15% drop in serum creatinine level, a decrease greater than 15% in mean blood pressure values or a decrease greater than 10% in mean blood pressure values with a reduction in the number of antihypertensive drugs needed for hypertension control. ResultsTechnical success was obtained in all patients [31/31; 100%; 95% confidence interval (CI): 89–100%] and clinical success in 27/31 patients (87%; 95%CI: 71–95%). Four patients (4/31; 13%; 95%CI: 5–29%) underwent repeat endovascular intervention. Mean serum creatinine level and mean arterial blood pressure values were significantly lower after treatment (177.4 and 93.8μmol/l, respectively) compared to before treatment (319.4 and 106.7μmol/l, respectively) in the stent group but not in the group treated with PTA alone (P=0.0012 and P=0.002, respectively). ConclusionThe endovascular approach is safe and effective in the management of TRAS and stenting, depending on the morphology of the stenosis, should be the treatment of choice when possible.

Effect of Diminazene aceturate treatment on some cardiovascular parameters and antioxidant status of apparently healthy horses

IntroductionApart from being a widely used antiprotozoal drug in many parts of Africa, Diminazene aceturate (DIZE), has been shown to have beneficial effects in experimental murine models of hypertension, pulmonary hypertension, myocardial infarction, stroke, atherosclerosis, type 1 diabetes, and eye disease. In this study, we investigated the effect of diminazene aceturate treatment after a single intramuscular administration on some cardiovascular parameters and antioxidant status in apparently healthy Nigerian horses.Materials and methodsTen male horses were divided into two groups comprising 5 horses each. Group A was the control group with no drug administered. Group B was treated with DIZE at 3.5 mg/kg, single dose. Baseline data were collected before the commencement of the experiment and thereafter, post‐administration at 0hrs, 24hrs, 48hrs and 96hrs. Base apex electrocardiogram was recorded using a computer ECG machine while oscillometric blood pressure measurement was recorded using a veterinary blood pressure monitor. Markers of oxidative stress were determined in the serumResultSingle intramuscular treatment caused a significant (p&lt;0.05) increase in the systolic, diastolic and mean arterial blood pressure values when compared with the controls. From the electrocardiogram, sinus rhythm was recorded in both groups however, significant (p&lt;0.05) increase in heart rate, p‐wave duration, QRS complex duration and QTc were observed in the treated group when compared with the control. Oxidative stress markers (malondialdehyde and hydrogen peroxide) significantly (p&lt;0.05) increased while antioxidant enzymes (catalase, glutathione peroxidase and glutathione) were decreased when compared to the control.ConclusionThis study indicates that the use of DIZE in horses should be with great caution because of the associated cardiovascular physiological alterations, reduction in activities of antioxidant enzymes and increase in markers of oxidative stress.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Postural hemodynamic parameters in older persons have aseasonal dependency : A pilot study.

AimsIt is known that blood pressure regulation differs seasonally. It is unknown, however, how the cardiovascular system in patients with a stroke reacts to postural changes in different seasons. The aim was therefore to investigate how different temperatures in cold and warm seasons influence the reactions of haemodynamic mechanisms as well as heart rate variability during a sit-to-stand test in patients with stroke and a control group.MethodsHemodynamic responses were assessed in both groups during a sit-to-stand test (5 min sitting followed by 5 min standing) beat to beat within two different seasons. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR), stroke index (SI), cardiac index (CI) and heart rate variability (HRV) were continuously monitored.ResultsDuring the sitting baseline period delta values of DBP (+15.1 [Standard error (SE) 3.75] mmHg, p < 0.05) and MBP (+14.35 [SE 4.18] mmHg, p < 0.05) were significantly higher in colder months compared to warmer months whereas SI (−3.86 [SE 1.43] ml/beat/m2, p < 0.05) and CI (−0.4 [SE 0.11] l/min/m2, p < 0.05) were lower in colder months compared to warmer months in non-stroke participants. In patients with stroke during sitting, baseline period delta values of DBP (+19.92 [SE 8.03] mmHg, p < 0.05) and MBP (+19.29 [SE 8.6] mmHg, p < 0.05) were significantly higher in colder months compared to warmer months but SI (−5.43 [SE 1.96] ml/beat/m2, p < 0.05) was significantly lower in colder months compared to warmer months. After standing, there was a significant decrease in SBP in warmer months (−16.84 [SE 4.38] mmHg, p < 0.05) and a decrease in DBP in warmer months (−7.8 [SE 2.3] mmHg, p < 0.05) and colder months (−6.73 [SE 1.5] mmHg, p < 0.05) in non-stroke participants and a decrease in MBP in warmer months (−12.5 [SE 2.8] mmHg, p < 0.05) and colder months (−8.93 [SE 1.8] mmHg, p < 0.05) in non-stroke participants and in warmer months (−14.54 [SE 4.1] mmHg, p < 0.05) in patients with stroke.ConclusionElderly with and without stroke respond to orthostatic stress with a greater drop in blood pressure in the warmer seasons.

Patterns of cardiovascular variability after long-term sino-aortic denervation in unanesthetized adult rats

Baroreflex dysfunction is a diffuse chronic condition that is expected to be followed by a profound loss of organization of BP and HR variability. Nevertheless, long-term effects of baroreflex withdrawal are still debated. Aim of our work was to study BP and HR changes long term after sino-aortic denervation (SAD). Inter-beat-interval (IBI) and intra-arterial BP were recorded beat-by-beat in 43 Wistar-Kyoto rats (Controls, n = 33; SAD rats, n = 10). Power spectra were calculated in controls and in SAD rats within three days and at seven months from denervation. Compared to controls, chronic SAD rats showed 1) similar mean BP (control vs SAD: 95 ± 16 vs 87 ± 22 mmHg) and IBI (171 ± 22 vs 181 ± 15 ms) values, 2) dramatically higher values of BP variance (12 ± 2 vs 64 ± 2 mmHg2, p < 0.01) and of ultra- (ULF) and very-low-frequency (VLF) BP oscillations, 3) dramatically higher values of IBI variability (24 ± 2 vs 71 ± 4 ms2, p < 0.01) and of ULF-IBI oscillations that were synchronized with BP oscillations. Chronic SAD rats reveal a marked change in the pattern of cardiovascular variability characterized by the appearance of synchronized slower oscillations of BP and HR. The cardiovascular system, therefore, retains a high level of organization despite the absence of a reflex control mechanism.

Labile hypertension: a new disease or a variability phenomenon?

Blood pressure (BP) is a physiological parameter with short- and long-term variability caused by complex interactions between intrinsic cardiovascular (CV) mechanisms and extrinsic environmental and behavioral factors. Available evidence suggests that not only mean BP values are important, but also BP variability (BPV) might contribute to CV events. Labile hypertension (HTN) is referred to sudden rises in BP and it seems to be linked with unfavorable outcomes. The aim of this article was to review and summarize recent evidence on BPV phenomenon, unraveling the labile HTN concept along with the prognostic value of these conditions.

English

This study aims to evaluate the effect of an intervention focused on medication adherence to improve blood at three basic health units in Maceio, Brazil. Patients were followed-up for three months. Primary outcomes were pressure control in patients with pseudoresistant hypertension. A randomized controlled clinical trial was conducted mean values of systolic blood pressure (SBP) and diastolic blood pressure (DBP). 185 patients were included, 145 of whom were randomly assigned to the experimental group, while 40 were allocated to the control group. After three months of follow-up, SBP did not change significantly in any of the groups; however, there was a significant reduction in DBP in the group submitted to intervention. Similar interventions given to patients with hypertension, without suspicion of resistant hypertension have focused exclusively on SBP. Key words: Resistant hypertension to conventional therapy, medication adherence, blood pressure.

Discrepancy between invasive and non-invasive blood pressure readings in extremely preterm infants in the first four weeks of life.

BackgroundThe agreement between invasive and non-invasive blood pressure (BP) readings in the first days of life of preterm infants is contentiously debated.ObjectiveTo compare mean, systolic and diastolic invasive (IBP) and non-invasive BP (NBP) readings obtained during routine care in the first four weeks of life of extremely preterm infants.MethodsWe extracted pairs of IBP and NBP readings obtained from preterm infants born below 28 weeks of gestation from the local database. After exclusion of erroneous measurements, we investigated the repeated measures correlation and analyzed the agreement (bias) and precision adjusted for multiple measurements per individual.ResultsAmong 335 pairs of IBP and NBP readings obtained from 128 patients, we found correlation coefficients >0.65 for mean, systolic and diastolic BP values. The bias for mean BP readings was -0.4 mmHg (SD 6.1), for systolic BP readings 6.2 mmHg (SD 8.1), and for diastolic BP readings -4.3 mmHg (SD 6.5). Overestimation of systolic IBP and underestimation of diastolic IBP by the non-invasive measurement were found both in the group with gestational age from 23 to 25.9 weeks and in the group with gestational age from 26 to 27.9 weeks. Systolic NBP readings tended to exceed invasive readings in the range <50 mmHg (bias 9.9 mmHg) whereas diastolic NBP readings were lower than invasive values particularly in the range >30 mmHg (bias -5.5 mmHg).ConclusionThe disagreement between invasive and non-invasive BP readings in infants extends to the first four weeks of life. Biases differ for mean, systolic and diastolic BP values. Our observation implies that they may depend on the range of the blood pressure. Awareness of these biases and preemptive concomitant use of IBP and NPB readings may contribute to reducing over- or under-treatment.

Impact of Low Caloric Diet and Exercise on Atherogenic Indices in Obese Hypertensive Adults

Abstract Background and aims: The influence of a low caloric diet with exercise were studied on several biochemical parameters including the lipid profile and atherogenic indices in overweight subjects including obesity with hypertension. Material and method: The study focused on 327 patients (144 men and 183 women) aged 54-73 years selected randomly, We chose hypertensives who live in the city of Tiaret and are over 50 years old, because it is the age group most affected by hypertension in Algeria and even in the world. We invited the subjects of our study to follow a program involving a low caloric diet, which was characterized by the suppression of the consumption of sucrose and refined white flour and by the choice of low-fat products, especially dairy products. Results: We observed a decrease in the mean value of blood pressure with its two components, systolic and diastolic. Systolic blood pressure ranged from 13.06 ± 1.40 cm Hg for the overall sample to 13.01 ± 1.12 cm Hg after the six-month program. The same finding is made for diastolic pressure, which decreased by 1.58% for the study population. For biochemical parameters, we observe a decrease in the mean value of all parameters after participation in the low-calorie diet and physical activity program, with the exception of HDL-c, which experienced an increase of 6.25%. Conclusions: The hypocaloric diet with exercise that we proposed to a group of hypertensives showed its effectiveness. A healthy lifestyle including a healthy and balanced diet with physical activity therefore allow better management of the hypertensive subject and could actually prevent atherosclerosis.

PHYSICAL PERFORMANCE, BODY COMPOSITION AND METABOLIC SYNDROME IN MILITARY PERSONNEL FROM THE BRAZILIAN ARMY

ABSTRACT Introduction: The Brazilian Army (BA) considers Military Physical Training (MPT) essential for the development of physical conditioning and general health, including prevention of chronic noncommunicable diseases (CNCDs), including metabolic syndrome (MS) risk factors. The evaluation of body composition using dual-emission x-ray absorptiometry (DXA) quantifies the visceral fat responsible for several types of disease. Objective: To verify the behavior among the body composition, anthropometric, hemodynamic and biochemical variables by means of the physical performance of military personnel with MS (W/MS) and without MS (NO/MS). Methods: The sample consisted of 41 (38.9 ± 2.3 years, 177.8 ± 6.4 cm, 91.5 ± 11.9 kg) military personnel, with 28 individuals diagnosed as W/MS and 13 individuals as NO/MS. Data collection was divided into three days. An anthropometric assessment was performed on the first day. On the second day, the subjects underwent biochemical tests of MS markers, blood pressure (BP) checks, and DXA examinations. On the third day, a physical assessment was applied according to the requirements of the BA (12-minute run, pushups and pullups). Results: There was a significant difference between W/MS and NO/MS subjects in the variables of HDL-C, Diastolic BP, Systolic BP and Waist Circumference. None of the physical variables presented a significant difference. There was also a significant difference between groups for all body composition and anthropometric variables. Conclusion: NO/MS subjects have better mean body composition, BP and anthropometric values than W/MS subjects, which may indicate that they are at less risk of CNCDs. The fact that the military subject is or is not a carrier of MS did not influence the performance of the tests applied. Level of Evidence I; Diagnostic studies - Investigation of a diagnostic test.

A4478 The Association Between Seasons And Ambulatory Blood Pressure In South Chinese Population

Objectives: Hypertension is independent predictors of stroke. However, the relative contributions of seasons to blood pressure is still not clear in South China. This study aimed to explore the pattern of seasonal changes of blood pressure in an South Chinese population and furthermore, to find out the association between evironment and blood pressure. Methods: 24-h ambulatory blood pressure monitoring was performed in total 631 patients. The systolic and diastolic BP values were calculated as the SD of individual blood pressure values during 24 h, daytime and nighttime.Multivariate linear regression models were used to assess the relationships between seasons and BP levels and BP load. Results: The mean values of blood pressure were (125.55 ± 12.59/70.63 ± 7.27)mmHg in spring, (128.97 ± 17.87/75.93 ± 9.53)mmHg in summer, (131.06 ± 14.02/75.16 ± 10.81)mmHg in autumn and (126.81 ± 12.69/71.63 ± 9.59) in winter. Systolic and diastolic mean blood pressures in 24-h, daytime and nighttime were different among subjects in different seasons(p < 0.05). Systolic and diastolic mean blood pressures in summer and autumn were higher than those in spring and winter. SBP load and DBP load were also different among seasons. However, the systolic and diastolic blood pressure variability (BPV) were similar in each season. Conclusion: Temperature and seasons were correlated with blood pressure level and BP load in South Chinese population.

A3672 Role of waist circumference in predicting elevated blood pressure among children and adolescents with normal body mass index

Objectives: To examine the waist circumference (WC)'s predict role to elevate blood pressure (BP) among children and adolescents aged 7–17 years old who have normal body mass index (BMI), and provide scientific evidence for prevention and intervention of elevated BP in children and adolescents. Methods: Data were combined from the China Health and Nutrition Survey, which was conducted during the period of 1993–2011. A total of 9038 children and adolescents aged 7–17 years old who had normal BMI were included in the final data analysis. Data were on gender, age, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the prevalence of elevated BP. After adjusted for sex and age, the multiple liner regression model was used to analyze the trend in mean BP with increase of WC levels. Logistic regression model was conducted to examine the trend in elevated BP prevalence and the risk of elevated BP with increase of WC levels. Results: Both the mean value of BP and prevalence of elevated BP showed rising trends with the increase of WC levels among children and adolescents with normal BMI (SBP/DBP ranged from 96.0/63.1 mmHg to 102.4/68.0 mmHg; prevalence of elevated BP ranged from 6.9% to 21.8%, all P < 0.001), independently of age and sex. When WC < P25 as the referent group, the risk for elevated BP were 1.39, 1.70, 2.21 and 3.10, for groups of WC > = P25 and WC < P50, WC > = P50 and WC < P75, WC > = P75 and WC < P90, and WC > = P90, respectively, independently of age and sex(P < 0.01). Conclusion: WC can be used as an important predictor of elevated BP in children and adolescents. BMI should be in combined with WC in order to more effectively prevent risk of elevated BP in children and adolescents.

A3464 The clinical effect and contrast evaluation of office blood pressure,ambulatory blood pressure mornitoring on treatment of Yinxu-Yangkang type of primary hypertensives by TCM of Tianma Gouteng Yin

Objectives: To observe the clinical curative effect and contrast evaluation of office blood pressure,ambulatory blood pressure monitoring on treatment of Yinxu-Yangkang type of primary hypertensives by TCM of Tianma Gouteng Yin. Methods: Total of 106 cases of Yinxu-Yangkang type of primary hypertension patients diagnosed by CBP and ABPM were randomly selected to take Tianma gouten Yin with 150 ml (tid) for 4 weeks, Then, the clinical curative effect, changes in CBP and 24 hours ABP were compared. Results: The clinical symptoms of patients were improved significantly and side effects were less; The DBP reducing at night was not significant difference (p > 0.05);All of blood pressure variability, nocturnal blood pressure drop rate and heart rate were not significant difference before and after treatment (p > 0.05); ***All of 24-hour average blood pressure, daytime and nighttime (only SBP) mean blood pressure,daytime and nighttime (only SBP) blood pressure load values had significant difference (p < 0.01 or p < 0.05) before and after treatment (p < 0.01 or p < 0.05);The office blood pressure is higher than the mean ambulatory blood pressure after treatment. Conclusion: It had better improving efficacy of clinical symptoms and tolerability, and less side effects in treatment of hypertension patients byTianma gouten Yin; The reasons and possiblities of lower antihypertension effect for DBP in nighttime of Tianma gouten Yin on ambulatory blood pressure may be follows:The evidence of dose-effect relation of evidence-based medicine is still short of; blood drug concentration is not easy to keep constant in nighttime;or the bioavailability is differences obviously. To explore some new taking ways of traditional Chinese medicine in treatment of hypertension are necessary.

Effects of isometric resistance training on blood pressure and physical fitness of men

Abstract AIMS The present study aimed to investigate the effects of whole body isometric resistance training (IRT) on blood pressure (BP), strength and aerobic fitness. We also analyzed whether the effects of whole body isometric training compares to whole body dynamic resistance training (DRT). METHODS Twenty-nine pre-hypertensive sedentary males, aged between 40 and 60 years were divided into three groups: IRT (n = 10), DRT (n = 9), and Control (n = 10). Both programs involved whole body resistance training, and occurred for 12 weeks, three times/week, at an intensity of 60% of a dynamic one repetition maximum test (1RM). Before and after 12 weeks, 24 hours blood pressure monitoring, 1RM strength and aerobic fitness were assessed. RESULTS IRT reduced diastolic BP values during a 24-hour period and daytime. There was also a decrease in mean BP values during daytime (P 0.05). IRT increased strength and aerobic fitness when compared to Control group. However, these changes were lower than DRT regarding strength (DRT: ∆ = 43.1±10.6% vs. IRT: ∆ = 24.1±7.1% vs. CON: Δ = 4.2±11.5%; P<0.05) and aerobic fitness (DRT: ∆ = 22.9±10.7% vs. IRT: ∆ = 12.9±6.1% vs. CON: Δ = -2.1±7.4%; P<0.01). CONCLUSION Whole body IRT reduced diastolic BP and mean BP, however, the decrease was not different for the DRT group. IRT also increased strength and aerobic fitness, nevertheless, these changes were lower than after DRT.

Evaluation of Cardiovascular Risk With Arterial Stiffness in Patients With Nonfunctioning Pituitary Adenoma

Nonfunctioning pituitary adenoma (NFPA) accounts for 30% of all pituitary adenomas, and its incidence has been increasing compared to previous years. Increased risk of cardiovascular effects shown in recent studies is noteworthy in patients with NFPA diagnosis, but the number of studies on the subject is limited. In this study, we aimed to assess possible cardiovascular effects and risk via arterial stiffness measurements in patients diagnosed with NFPA. We performed arterial stiffness measurements for 30 patients diagnosed with NFPA and 30 healthy volunteers and compared the results to explore the relationship between arterial stiffness parameters, hormone levels, and adenoma size. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), central SBP, central DBP, augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and pulse wave velocity (PWV) values of the patients with NFPA diagnosis were significantly higher than the control group. PWV was found to have a significant and negative correlation with growth hormone and insulin-like growth factor 1 (IGF-1). A significant and positive correlation was found between adenoma median short-axis length and PWV. IGF-1 was found to have a significant and negative correlation with adenoma median long- and short-axis length. In multivariate linear regression analysis, we found that IGF-1 was an independent predictor of PWV. Both arterial stiffness parameters such as AIx@75 and PWV and peripheral SBP, DBP, and MBP values were found to be high in NFPA patients with no cardiovascular risk factors. Our findings suggest increased cardiovascular effect and risk in patients with NFPA diagnosis, and therefore, we recommend that patients are monitored closely in this respect. ACTH = adrenocorticotropic hormone; AIx@75 = augmentation index corrected for a heart rate of 75 beats per minute; BMI = body mass index; CVD = cardiovascular disease; DBP = diastolic blood pressure; FSH = follicle-stimulating hormone; GH = growth hormone; HT = hypertension; IGF-1 = insulin-like growth factor 1; LH = luteinizing hormone; MBP = mean blood pressure; MRI = magnetic resonance imaging; NFPA = nonfunctioning pituitary adenoma; PP = pulse pressure; PWA = pulse wave analysis; PWV = pulse wave velocity; SBP = systolic blood pressure; TSH = thyroid-stimulating hormone.