Mean Values Of Systolic Blood Pressure Research Articles

CAN PATIENTS WITH CARDIOVASCULAR RISK FACTORS AND DIFFERENCE BETWEEN OFFICE AND OUT-OF-OFFICE BP MEASUREMENTS BENEFIT FROM ABPM?

Objective: Blood pressure (BP) is a dynamic parameter characterized by fluctuations during the 24-hour period. During the nighttime hours, BP drops 10-20% in normotensive and untreated hypertensive patients - a dipping phenomenon, followed by a rapid and gradual increase during waking hours. The dipping phenomenon can be checked by Ambulatory Blood Pressure Measurement (ABPM). The main clinical indications for ABPM, suggested by the available studies, are white-coat phenomena, masked hypertension, and nocturnal hypertension. Design and method: Our study involved 45 patients with over 20% difference between office and out-of-office blood pressure measurements. We checked their medical history for other cardiovascular risk factors, such as Dyslipidemia, Diabetes Mellitus, Coronary Disease. Our patients were under 24 hour- ABPM and they were classified according to the rate of fall in systolic BP during 24-hour recording into four categories: the extreme-dippers drop >20%, dippers drop >10% and <20%, non-dippers drop <10% and >0%, and reverse-dippers or risers drop <0%. The purpose of our study is to consider the significance of ABPM in specific target groups of patients with cardiovascular risk factors. Results: In our study 44 patients participated (56,8% men) with mean age 55,9 and mean value of systolic BP 120,7mmHg. 40,9% of the patients had a history of hypertension, 36,4% dyslipidemia, 15,9% diabetes mellitus and 11,4% coronary disease. 77,3% of the patients were judged to be normotensive, but 35,3% of them had a history of hypertension and were under medication, only 11,4% were judged to be hypertensive, 6,8% with isolated diastolic hypertension and 4,5% with isolated systolic hypertension. According to ABPM, we changed medication in 29,5% of the patients. 76.9% of them had already history of hypertension and were under medication, 38,5% had dyslipidemia and 30,7% diabetes mellitus and coronary disease. Conclusions: In our study we were not able to demonstrate that patients with difference between office and out-of-office BP measurements and cardiovascular risk factors could benefit most from ABPM but we demonstrated that patients with a history of hypertension could benefit form ABPM, so that physician could choose the appropriate treatment.

Comparative study between cuff sizes in the determination of systolic blood pressure, by non-invasive methods in anesthetized dogs

The measurement of systolic blood pressure (SBP) is a variable of paramount importance in clinical routine, obtained and measured according to published guidelines for dogs. The study evaluated the influence of cuff size on the determination of systolic blood pressure (SBP) values in dogs, comparing two non-invasive methods. Eighteen healthy dogs of different breeds and ages were used, clinically evaluated and undergoing elective surgeries. SBP was measured using vascular Doppler and high-definition oscillometric methods during the anesthetic period, using both ideal-sized cuffs and smaller cuffs. The dogs were divided into groups, Group 1 composed of dogs with ideal cuff no. 2, Group 2 dogs with ideal cuff no. 3 and Group 3 ideal cuff no The results showed that smaller cuffs significantly overestimated the mean SBP values compared to the ideal cuff values, regardless of the method used. It was concluded that cuffs with a lower than ideal number overestimate SBP values in anesthetized dogs, regardless of the non-invasive method used.

Effect of Beet Root (Beta vulgaris), White and Red Radish (Raphanus sativus and Raphanus longipinnatus) Juice Extract, on Salt Induced Hypertensive Wistar Rats

Background: Hypertension is one of the major global health challenges with high prevalence and undesirable complications, and is a major cause of premature death worldwide.
 Objective: This study was conducted to evaluate the effect of juice extracted from beetroot (BR), red radish (RR) and white radish (WR) tubers on experimentally induced hypertension in 10-week-old Wistar rats.
 Methodology: Total of 35 rats was randomly divided into seven (7) experimental groups A - G with 5 rats each. Rats in group A were not induced (normotensive group). All the rats in groups B-G were induced with hypertensive agent. Group B was not treated (negative control), groups C-G were treated simultaneously with a dose of 800 mg/kg body weight (orally) of BR, RR, WR, BR+RR combination, and standard drug (5mg Amlodipine) respectively. The study lasted for a period of 28 days during which the blood pressure and heart rate (HR) of each of the experimental rats were measured at 0, 7, 14, 21 and 28th day using Stethoscope technique. The interpretation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were made from pulse tracings using Aneroid Sphygmomanometer. The mean blood pressure (MBP) was calculated from SBP and DBP.
 Results: The BR, RR, WR and combination of BR+RR, did decrease the number of heart beats/minute from 192.00/minute to 208.80/minute which is within the normal base line, whereas the untreated rats recorded increase from 192.00/minute to 246.80/minute. The result showed that the hypertensive rats recorded higher (P<0.05) mean values of SBP, the treated groups altered the rise from 110.40 mmHg to 100.40mmHg with the standard drugs, followed by the white radish treatment group, the combination of BR+RR, before RR, lastly the BR group. For DBP, at week 4, same impact reflected again, but week 2 and week 3 had WR to have the best effect, followed by BR +RR, then RR before the standard drug and then Beetroot. The BR + RR juice performed better than the individual RR and BR juice groups, suggesting possible synergistic effect.
 Conclusion: The 3 juice extracts had demonstrated varying degrees of protection, provided scientific evidence of their anti- hypertensive activities in an experimentally induced hypertension. Further studies are hereby recommended to isolate the specific biomolecule active agent(s) and investigate the mechanism of action.

Triple fixed-dose combination of amlodipine, indapamide and perindopril for hypertension in patients with stable coronary artery disease and abdominal obesity

Aim. In an open-label clinical trial, to evaluate the effectiveness and impact on metabolic parameters of triple antihypertensive combination therapy with amlodipine, indapamide and perindopril arginine (perindopril A) in patients with hypertension (HTN) and stable coronary artery disease (CAD) in combination with abdominal obesity (AO), who have not had an adequate response to dual antihypertensive therapy for at least 4 weeks.Material and methods. The study included 68 adult patients aged 42 to 64 years (51 (47; 60) years) with AO, stable CAD and uncontrolled HTN, despite treatment with two drugs: an angiotensin-converting enzyme (ACE) inhibitor and a thiazide and thiazide-like diuretic. In the study, patients, in accordance with the general characteristics of the drug, after prescribing a free triple-dose combination of amlodipine, indapamide, perindopril in appropriate dosages, received one of the following combination of amlodipine/indapamide/perindopril for 24 weeks: group 1 (n=34) — 10/2,5/10 mg and group 2 (n=34) — 5/1,25/5 mg, one tablet daily. The analysis of the primary endpoint was to assess the change in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the sitting position from baseline to 24 weeks. Secondary efficacy endpoints included the proportion of patients achieving target mean SBP and DBP values for this category in the sitting position of 120-130 mm Hg and 70-79 mm Hg, respectively, at 12, 16, 20 and 24 weeks. Safety was assessed throughout the study. The effect on metabolic parameters was assessed at 24 weeks of the study.Results. Sixty-seven (98,5%) patients completed the study. The mean decrease in blood pressure from the initial level (group 1159/96 mm Hg; group 2161/95 mm Hg) to 24 weeks (group 1 126/76 mm Hg; group 2 132/84 mm Hg) was significant (p<0,0001 for all). The proportion of patients who reached the target mean values of SBP (120-130 mm Hg) and DBP (70-79 mm Hg) in the sitting position by 24 weeks was 80,16% and 79,28% in group 1, respectively; in group 2 — 65,32% and 70,06%, respectively. No serious adverse events were recorded. Its administration, regardless of the doses of individual components in combination, was accompanied not only by metabolic neutrality in relation to carbohydrate, lipid and purine metabolism, a decrease in chronic inflammation, but was also associated with a decrease in serum leptin concentration and subcutaneous adipose tissue, an increase in tissue sensitivity to leptin, as well as a decrease in the size of adipocytes in subcutaneous fat.Conclusion. Triple fixed-dose of amlodipine/indapamide/perindopril in two different dosages is effective, safe and well tolerated in patients with HTN and stable CAD in combination with AO.

The course of arterial hypertension in patients with type 2 diabetes after surgical treatment of carotid artery stenotic lesions

Background. Arterial hypertension (AH) is the cause of 70–75 % of strokes. Atherosclerotic lesion of the carotid artery (CA) is a classic example of a vascular lesion in individuals with hypertension. The risk of stroke increases twice when hypertension and diabetes are combined. Carotid endarterectomy (CA), which has both a curative and preventive nature, is the main method of surgical treatment of CA stenoses. The purpose was to study the course of blood pressure in patients with type 2 diabetes and without it after CE. Materials and methods. 138 patients with arterial hypertension and CA stenosis were selected for the purpose of CE under local anesthesia. Patients were divided into two groups: 68 patients with type 2 diabetes (group I) and 70 patients without diabetes (group II). The median age of patients in group I was 64 [50–71] years, group II — 63.5 [47–68] years. Daily blood pressure monitoring (BPD) was performed 2 days before surgery (1 examination), 5–7 days after surgery (2 examinations) and 3–6 months after CE (3 examinations). The average indicators of systolic blood pressure (SBP) and diastolic blood pressure (DBP) per day, day, and night were evaluated; average pulse blood pressure (BP); variability of SBP and DBP per day, day, night. Results. Before the operation, group I, in contrast to group II, recorded significantly higher indicators: SATdb (p = 0.02), SATd (p = 0.03), SATn (p = 0.01), DBTn (p < 0, 05), PAT (p = 0.03), varDATdb (p = 0.03), varSATd (p = 0.03), varDATn (p = 0.04). During the second examination in group II, significantly more significant dynamics of DMAT indicators were noted: SATdb (p = 0.002), SATd (p = 0.02), DAPdb (p = 0.002), DAPd (p = 0.01), DAPn (p = 0.03), varSATn (p < 0.04), varDATn (p < 0.05), varSATdb (p = 0.0002), varDATdb (p = 0.0001). The dynamics of PAT and midnight SAT were insignificant. 3 months after KE, all mean values of SBP and DBP, as well as PAT, decreased significantly in patients of group II. The expressiveness of changes in SBP indicators during the day, day and night, as well as indicators of SBP variability in group II was more significant. During the third examination, the proportion of patients with a "dipper" circadian rhythm increased in the two groups (p < 0.05). In group II, the proportion of patients with an unfavorable type of daily profile "over-dipper" significantly decreased (p < 0.001), which did not occur in group I. Conclusions. Surgical treatment of carotid stenoses in patients with and without type 2 diabetes is associated with a decrease in blood pressure in the early postoperative period and is observed for several months after the operation.

The Relationships Between Blood Pb Levels and Blood Pressure Among Lead-Exposed Workers in China: A Repeated-Measure Study.

To explore the differences in the increase of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in 3 consecutive years among lead (Pb) workers. Four hundred forty-eight Pb workers were enrolled in this repeated-measure study. Blood Pb, SBP, and DBP were measured in 2015 to 2017. Repeated measure of analysis of variance was used to compare the differences in the increase of SBP and DBP. The mean SBP values were 124.0/125.5/126.9 mm Hg, and the mean DBP values were 75.4/77.4/77.8 mm Hg from 2015 to 2017. The differences in the increase of SBP and DBP were 2.94/2.42 mm Hg during the 3-year period. The average annual increase of SBP or DBP showed an upward trend in different Pb dose groups ( F = 4.904, P = 0.002; F = 3.612, P = 0.013). Lead exposure caused average annual increases in SBP and DBP with 0.98 and 0.81 mm Hg, which provided basic data for health surveillance.

A Comparative Accuracy Study of Touch-based Non-invasive Blood Pressure Feature of Device- H360

Background: To take blood pressure (BP) measurements repeatedly is beneficial for managing the control of hypotension and hypertension. Now present readings depend on cuff-based technology. This study compared blood pressure readings taken with new device without cuff photo plethysmography – PPG with a typical mercury-based sphygmomanometer apparatus.Purpose:A comparative accuracy study of the touch-based non-invasive blood pressure (NIBP) feature of device H360 compared with a mercury-based sphygmomanometer.Material and method: The study was conducted among 95 participants (Above 18 years) at Apex Heart Institute, Ahmedabad from 08th December 2022 to 07th January 2023. We concluded the study on three major factors like age, gender, and health status of participants with hypertensive (n=12), hypotensive (n=18) and normotensive (n=65). Hypotensive and normotensive).Results: According to our observations, the results of the study revealed substantial variations between the three groups in terms of the standard deviation (STD), mean value of systolic blood pressure (SBP) and diastolic blood pressure (DBP), as measured by both the H360 and the mercury sphygmomanometer work on the principle that measures blood pressure by constricting the brachial artery with an inflatable cuff. The cuff is inflated until blood flow stops, then slowly deflated until a tapping sound is heard, indicating blood flow resumption. The pressure at which the sound is heard is the systolic blood pressure, while the pressure at which it disappears is the diastolic blood pressure. The mean values of SBP and DBP were highest in the hypertensive group, followed by the normotensive group, and lowest in the hypotensive group.Conclusion: The study concluded that the device H360 device and mercury sphygmomanometer were effective in measuring blood pressure in hypertensive, hypotensive, and normotensive individuals. However, the H360 showed better accuracy and consistency in measuring blood pressure with a mercury sphygmomanometer.

Blood pressure in healthy term and late preterm newborns in Mexico City.

Describe the measurements of systolic, diastolic and mean blood pressure in healthy term and late preterm newborns to establish normal values. Cross-sectional study carried out in the nursery of the Hospital Español, located in Mexico City. A sample of 551 healthy newborns were included in the study. Blood pressure (BP) measurements were taken within the first 48 hours of life with the oscillometric method. After the evaluation of normality, a descriptive analysis of the population and calculation of percentiles (25, 50 and 75) specific for each week of gestation was performed. All analyzes were performed in STATA v14.2. Male newborns had a mean SBP value of 64.6 mmHg at week 35 of gestation, this value increased to 69.8 mmHg at week 40; the systolic blood pressure (SBP) value was 42.6 mmHg at week 35 of gestation, which decreased to 40.8 mmHg at week 40. The mean SBP values in female newborns were 65.5 mmHg at week 35, increasing to 73.5 mmHg at week 40; the diastolic blood pressure (DBP) value at week 35 of gestation was 38 mmHg, increasing to 41.3 mmHg at week 40. The BP values in healthy newborns are modified by the gestational age and sex of the patients. These results can serve as a reference for other physicians located in countries or cities with a similar altitude than the one in Mexico City.

Predictors of Perioperative Hypertensive Crisis in Patients With Pheochromocytoma: A Retrospective Study

Background: Pheochromocytoma is a rare adrenal gland tumor. The definitive treatment is an adrenalectomy. Because of its secretory nature, appropriate preoperative treatment is essential to prevent hypertensive crisis (HTC) during surgery. Despite this management, HTC is common and can cause life-threatening complications. We aimed to study variables that may affect HTC despite preoperative management. Methods: In a retrospective study, among 126 medical records of patients with adrenal tumors who were referred to Alzahra Hospital, Isfahan, Iran, between 2013 and 2021, 52 patients who took proper preparation for surgery were included. Results: Analysis of these patients (aged 15 - 72 years, 30 females) showed that 12 patients (23.1%) experienced HTC. The mean age in the HTC group was 44.0 ± 15.3 and in the non-HTC group was 45.6 ± 13.2 (P = 0.724). Among many potential predictors, we observed in a multivariate analysis that patients with tumors size > 33.5 mm were at higher risk for experiencing HTC (P = 0.038, odds ratio (OR): 13.1, confidence interval (CI): 1.26 - 135.26); taking amlodipine to help reduce blood pressures (BPs) was another significant predictor (P = 0.05, OR: 5.1, CI: 0.97 - 56.74). Mean values of systolic BP (SBP) and diastolic BP (DBP) before surgery in the HTC group were more, although it was not statistically significant. Patients’ past medical history, 24-h urine metanephrine, normetanephrine, epinephrine, norepinephrine, vanillymandelic acid (VMA), and surgical technique were not significantly distributed between HTC and non-HTC patients (P > 0.05). Conclusion: Tumor sizes > 33.5 mm and the necessity of administering amlodipine to control BP were predictors of HTC. Due to the rarity of pheochromocytoma, multicenter studies with larger sample sizes for providing more reliable results are suggested. J Endocrinol Metab. 2023;13(1):20-32 doi: https://doi.org/10.14740/jem853

Blood Pressure Reference Values of Nigerian Full-term Neonates in the First Week of Life at a Nigerian Tertiary Hospital: A Cross-sectional Survey

Introduction: Knowledge of normative Blood Pressures (BP) is critical for appropriate neonatal care. Hypertension and hypotension are abnormalities of BP which could be a sign, outcome or complications of diseases or intervention carried out on neonates. Yet, there is a dearth of data on BP concerning Nigerian full-term neonates. Aim: To determine BP values of apparently healthy term Nigerian neonates in relation to their weight in the first eight days of life and also to determine the BP values of apparently healthy term neonates in the first eight days and also to correlate the BP with postnatal age, weight and to generate percentile of age/sex specific BP. Materials and Methods: This cross-sectional study was done from September 2012-April 2013, including 386 consecutive apparently healthy term newborns delivered at the UNIOSUN Teaching Hospital (UTH), Osogbo, Southwest Nigeria. Their weights and right arm Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) BPs measured using oscillometric method on days 1, 3, 5 and 8. Student’s t-test and Pearson correlation coefficient was used to statistically analyse the data. Results: Out of 386 newborns studied, the mean birth weight were 3.10±0.38 Kg; {3.24±0.37 kg for boys and 2.97±0.33 kg for girls}. The mean values of SBP on day 1 were 67.3±5.6 mmHg; 71.0±6.0 mmHg on day 3; 73.8±5.2 mmHg on day 5 and 77.2±2.9 mmHg on day 8, respectively. A similar trend was also noticed in the mean values of DBP with 36.9±5.0 mmHg on day 1; 41.5±5.2 mmHg on day 3; 43.7±5.3 mmHg on day 5 and 46.4±4.7 mmHg on day 8, respectively, the rise being significant (p-value <0.001). There were a positive correlations between the weight and DBP on the 5th day (r=0.128; p-value =0.012), between weight and SBP at 49-72 hours and on day 8 (r=0.105; r=0.168, respectively) as well as weight and MAP on day 8 (r=0.166). Conclusion: Neonatal BP in the first eight days following birth correlated positively to weight and age without significant gender differences.

UNATTENDED AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENT VERSUS CLASSIC OFFICE AUTOMATED BLOOD PRESSURE MEASUREMENT IN A HYPERTENSION OUTPATIENT CLINIC

Objective: Accurate measurement of blood pressure is a fundamental pre-requisite requirement for an appropriate management of arterial hypertension. In order to eliminate the well-known limitations of classic office blood pressure measurements, the so-called unattended automatic office blood pressure measurement method can be a solution. Design and method: In 52 patients arriving for regular follow-up into one of the Hypertension Outpatinet Clinic of the Nephrology-Hypertension Center of the University of Szeged 3–3 blood pressure measurements were made at 1–1 minute intervals first by a doctor with an MIT5 automatic device and then in a separate room unattended, starting alone by the patient with a Hem-907 device. We also included the patients’ home blood pressure in the comparison, which was recorded on the basis of the home diaries they kept. Results: Based on our results, the MIT5 device had the highest blood pressure values of the three modalities, both in terms of systolic and diastolic values. The mean systolic blood pressure values measured with MIT5 device were signifincantly higher but not with Hem-907 device compared to home blood pressure values (p = 0.004). Diastolic values measured with MIT5 were significantly higher compared to Hem-907 (p < 0.001) and compared to home measurements (p = 0.001). Forty-nine percent of the patients had blood pressure in the goal range both with MIT5 and Hem-907 device, and 29% with both methods above the goal range. If only one measurement had been taken in each patient during the study, a much higher rate of hypertension would be included in the data. Conclusions: Our results support the use of unattended automated office blood pressure measurements in the everyday practice. Whether Hem-907 or other devices should be used is another matter.

Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial.

Mud pack or compress is an easily accessible, cost-effective, efficient treatment modality used in naturopathy to manage and prevent various chronic illnesses. This study sought to elucidate the effectiveness of cold spinal mud packs on improving neuro-cardiac parameters among hypertensive individuals. A total of 100 hypertensive subjects aged 30-50 years were randomly allocated into two groups: Cold spinal mud pack (CSMP) and prone rest. Blood Pressure (BP) and Heart Rate Variability (HRV) were assessed at three-time points: Baseline, After 20min (T1), After 60min (T2). This single-blinded randomized controlled trial was registered in the Clinical Trials Registry-India (CTRI/2019/12/022492). After 20min of CSMP showed a statistically significant reduction (p<0.01) in mean values of Systolic BP, Diastolic BP, and in HRV attained statistically significant change (p<0.01) in mean score in the frequency domain except for Very low-frequency power (VLF) and a significant difference found in the mean score of time-domain values (p<0.01) when compared to control group and 95% confidence interval (CI) will be provided for each effect. CSMP reduces the sympathetic tone and shifts the sympathovagal balance in favor of parasympathetic dominance, contributing to a decrease in BP and effective changes in components of HRV.

Influence of Eversion Endarterectomy and Patch Reconstruction on Postoperative Blood Pressure After Carotid Surgery

Post carotid blood pressure fluctuation and hypertension (PEH) are associated with increased risk for adverse outcome; there is limited evidence on the impact of eversion endarterectomy (E-CEA) versus conventional endarterectomy with patch closure (C-CEA) on postoperative blood pressure course. In this retrospective observational study, 859 consecutive carotid endarterectomy procedures between 2004 and 2014 (C-CEA n=585 vs. E-CEA n=274), were evaluated. Pre- and postoperative blood pressure values were recorded from recovery room until third postoperative day and compared between both techniques; influences on the dichotomous target variable "at least one postoperative blood pressure peak", that is need for postoperative vasodilators, were analyzed by a logistic regression model. Influences on postoperative systolic blood pressure were evaluated by a linear mixed effects regression model. Preoperative baseline blood pressure was not different between both comparison groups. During postoperative course, significantly increased mean systolic blood pressure values in the E-CEA group from recovery room to second postoperative day (recovery room C-CEA: 129.2 mm Hg vs. E-CEA: 136.5 mm Hg; P < 0.001; first postoperative day C-CEA: 132.4 mm Hg vs. E-CEA: 139.3 mm Hg; P=0.0002; second postoperative day C-CEA: 138.6 mm Hg vs. E-CEA: 143.1 mm Hg; P=0.023) were observed. No hyperperfusion syndrome was detected as wells as no difference in postoperative complication rate. Frequency of antihypertensive interventions was also elevated in E-CEA group (C-CEA 22.1 % vs. E-CEA 31.8 %; P=0.003). E-CEA (OR 1.591, 95% CI [1.146; 2.202]; P=0.005) and presence of preoperatively elevated systolic readings (OR 1.015, 95%CI [1.006;1.024]; P < 0.001) was also associated with increased need for antihypertensive interventions. E-CEA was associated with significantly elevated postoperative blood pressure, compared to C-CEA. C-CEA was associated with postoperative blood pressure decrease; however, no difference as to neurologic and surgical complications was detected between both surgical techniques in clinical practice.

Associations between nocturnal continuous blood pressure fluctuations and the characteristics of oxygen desaturation in patients with obstructive sleep apnea: a pilot study

BackgroundPatients with obstructive sleep apnea (OSA) frequently experience apnea-related oxygen desaturation events (ODE) accompanied by striking blood pressure (BP) fluctuations during sleep. We aimed to investigate the effects of characteristics of ODE on nocturnal BP fluctuations in OSA patients. Methods and resultsA total of 6199 ODE were obtained from 30 patients with who underwent overnight portable monitoring and beat-to-beat BP monitoring simultaneously. The associations between nocturnal BP parameters and the characteristics of ODE were studied. The mean value of systolic BP (SBP) monitored during ODE was higher than the non-hypoxia SBP value (122.0 ± 15.9 vs. 120.4 ± 15.1 mmHg, P = 0.001) and nighttime SBP value (122.0 ± 15.9 vs. 120.8 ± 15.0 mmHg, P = 0.002). SBP variability (SBPV) during ODE was higher than the values not during ODE (14.0 ± 2.8 vs. 13.2 ± 2.6 mmHg, P = 0.043) and nighttime SBPV (14.0 ± 2.8 vs. 12.9 ± 2.3 mmHg, P < 0.001). Hypoxia SBP index, defined as the percentage of SBP surge (△SBP) ≥10 mmHg to all △SBP during ODE, increased with greater respiratory event index (P = 0.01). Both the coefficient of variation for SBP values of an ODE (SBPV′) and event-related SBP elevation (△SBP′) increased with raised amplitude of ODE (P < 0.001 for SBPV′ and P < 0.001 for △SBP′). Similar results were observed when the duration of events was analyzed (P < 0.001 for SBPV′ and P < 0.001 for △SBP′). ConclusionBP related to ODE may be the main component of increased BP during sleep in OSA patients. In addition to the frequency of respiratory events, the amplitude and duration of ODE may have a role in nocturnal BP fluctuations in OSA patients.

HIGH PREVALENCE OF HIGH BLOOD PRESSURE AND EXCESSIVE BLOOD PRESSURE REDUCTION IN PATIENTS WITH “CONTROLLED” ARTERIAL HYPERTENSION AFTER MYOCARDIAL INFARCTION AND STROKE

Objective: Arterial hypertension (AH) is important risk factor and its control is a cornerstone of primary and secondary prevention. On the other hand, excessive blood pressure (BP) reduction may be harmful, especially in patients with the history of ischemic events. To assess AH control we performed 24-hours ambulatory blood pressure monitoring (ABPM) in patients with AH in remote period after myocardial infarction (MI) or ischemic stroke (IS) in whom AH was believed to be controlled accordingly BP office measurements. Design and method: 64 patients with AH and previous (at least 6 months after) MI (39 patients, 64.1% men) and IS (25 patients, 36.0% men) with normal office BP (120–139 mm Hg/60–89 mm Hg) during two consecutive visits were involved into the study. ABPM was performed and mean values of systolic BP (SBP) and diastolic BP (DBP) were assessed. Excessive BP reduction (EBPR) was considered as SBP below 100 mm Hg at daytime. Prolonged EBPR was considered as EBPR more than 1 hour of consecutive measurements. Results: Groups did not differ significantly in age, body mass index, glomerular filtration rate, number of antihypertensive drugs, prevalence of diabetes. Mean 24-hour SBP was higher in IS group (131.9/76.4 ± 11.7/7.3 mm Hg) comparing to 118.5/71.3 ± 11.0/9.0 mm Hg in MI group (p &lt; 0,00001 for both SBP and DBP). Mean 24-hour SBP higher than 140/90 mm Hg was found in 28.0% patients in IS and only in 2.6% patients in MI group (p = 0.002). Much more episodes of EBPR were detected in MI than in IS group (10.2 ± 10.8 vs 4.0 ± 3.9, p = 0.008) and number of patients with at least one prolonged EBPR was also higher in MI group (23.1% vs 8.0%). Patients with prolonged EBPR did not differ significantly in age, body mass index, glomerular filtration rate, prevalence of diabetes and number of antihypertensive drugs. Conclusions: Around a quarter of patients in remote period after IS had high BP levels whereas similar proportion of patients after MI had prolonged episodes of excessive hypotension during ABPM. Office BP measurements may be not sufficient to detect inadequacy of AH control in secondary prevention.

UNCOVERING ASSOCIATIONS BETWEEN BLOOD PRESSURE PHENOTYPES AND IMMUNE TRAITS IN TWINSUK

Objective: The primary aim of this work was to define the contribution of both the innate and adaptive immune system arms to blood pressure changes. Design and method: In order to define the inter-relationships between immune cell subtypes, blood pressure (BP) and susceptibility to hypertension (HT), we carried out association analyses between 23,394 immune phenotypes and blood pressure measures [systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP)] and HT. After calculating the mean SBP and DBP values from two BP measurements, we adjusted for medication use by adding 15- and 10-mm Hg to SBP and DBP respectively for individuals reported to be on BP-lowering treatment. PP was calculated as SBP minus DBP according to medication adjusted traits. HT was defined as (i) SBP&gt;=140 mm Hg, (ii) DBP&gt;=90 mm Hg or taking BP-lowering medication. We undertook a comprehensive and high-resolution deep immunophenotyping flow-cytometry approach, to examine immune traits in 502 female twins from TwinsUK. The platform used covered all major lymphocyte and myeloid subsets in peripheral blood. A linear/logistic mixed model regression analysis adjusted for family structure, age and BMI was used to examine the associations between immune traits and blood pressure phenotypes and HT status respectively. Results: We observed statistically significant associations (Bonferroni P-value &lt; 1.71x10–4) between blood pressure phenotypes and immune cell subtypes. In particular, DBP showed 47 significant associations with distinct myeloid cell types of CD8 differentiation T cells. SBP showed 59 significant associations with both CD8 differentiation T cells and specific myeloid subpopulations such as monocytes. PP showed 4 significant associations with monocyte subpopulations. Analysis of HT revealed 7 associations with monocytes, CD8 T cells and dendritic cells. Conclusions: The results reported in this study provide preliminary evidence of an inter-relationship between blood pressure and human immune cell profile associations. We have shown for the first time that change in the proportions of immune cells correlates with blood pressure measurements.

Effect of Blood Pressure Management Strategies on Outcomes in Patients with Acute Ischemic Stroke After Successful Mechanical Thrombectomy

Variability, with no general consensus, exists in how patients' blood pressure should be managed after successful mechanical thrombectomy (MT) for large vessel ischemic stroke. We examined whether exceeding the systolic blood pressure (SBP) targets in patients during the first 24 hours after successful MT led to worse outcomes. We retrospectively studied a consecutive sample of adult patients who had undergone MT. We collected SBP data for the first 24 hours after MT and categorized the patients into 3 groups according to cases of the SBP exceeding 140, 160, or 180 mm Hg. The primary and secondary outcomes were the modified Rankin scale score at discharge and 90 days of follow-up, the incidence of symptomatic intracranial hemorrhage, malignant cerebral edema, and hemicraniectomy, mortality within 90 days, and discharge disposition. A total of 117 patients were included (mean age, 65 ± 13.12 years; 53% female). The occurrence of ≥1 instance of SBP ≥180 mm Hg was significantly associated with poor functional outcomes at discharge (adjusted odds ratio [OR], 5.83; 95% confidence interval [CI], 1.41-32.9; P= 0.025) but not at 90 days of follow-up. The occurrence of SBP ≥160 mm Hg resulted in an independently increased odds of malignant cerebral edema (adjusted OR, 17.07; 95% CI, 2.56-174.4; P= 0.01), with a trend toward increased odds of symptomatic intracranial hemorrhage (adjusted OR, 4.42; 95% CI, 1.03-21.2; P= 0.0503). These results suggest that individual instances of SBP elevation alone after successful MT, rather than a necessarily prolonged increased blood pressure as reflected by the mean or median SBP values, can significantly affect the clinical outcomes after successful MT.

Comparative study of ankle brachial pressure index and blood sugar profile among offspring of diabetic and non-diabetic parents in early detection of peripheral arterial disease

Background: Type 2 diabetes mellitus (T2DM) is a complex disorder which is caused by a composite combination of genetic, epigenetic, and environmental factors. One of the most contributing quantitative risk factors is family history. The prevalence of peripheral arterial disease (PAD) in T2DM ranges from 20% to 30% and the lifetime risk of developing diabetes is up to 40% if either of parents is type 2 diabetic. Aim and Objectives: The aim of the study was to know whether non-diabetic offsprings of diabetic parents having chances of becoming diabetic and to have PAD in future part of life. Material and Methods: Taking all inclusion and exclusion criteria into consideration, 50 offsprings of diagnosed diabetic parents (>5 years) were taken as cases, and 50 healthy age-matched offsprings were taken from non-diabetic parents as controls. A thorough physical and systemic examination were done. After getting informed written consent, anthropometric measurements, FBS, PPBS, HbA1c, were measured. By taking ankle systolic blood pressure (SBP) and brachial SBP, ankle-brachial pressure index (ABPI) was calculated using a hand held vascular Doppler. Statistical analysis was done by Student’s t-test in SPSS software. Results: The mean HbA1c (%) level for controls was 5.68 ± 0.35 and for cases was 5.85 ± 0.44 with a P-value of 0.035 (significant). Similarly mean values for ankle SBP (mm Hg) were 148.4 ± 17.33 in controls and 159.8 ± 23.66 in cases with a P-value 0.0071 (significant). About 32% of controls and 50% of cases showed a non-compressible ABPI (ncABPI) arteries of >1.3, whereas only 2% of cases showed a typical ABPI of PAD, that is,

Abstract 14317: Kidney Function Deterioration is Dependent on Blood Pressure Levels: 11.2-year Follow-up in Diabetic Patients

Introduction: Blood pressure (BP) is a significant predictor for chronic kidney disease (CKD). Hypothesis: We sought to evaluate whether the progression of CKD in diabetic patients, without a history of atherosclerotic events, is dependent on BP control. Methods: The Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial was a multicenter, prospective, randomized, open label, blinded, end-point study done from 2002 to 2008. After completion of the JPAD trial, we followed up the patients until 2019. We defined late-stage kidney disease (LSKD) as estimated glomerular filtration rate (eGFR) &lt;30 ml/min/1.73m 2 or hemodialysis. Among 2,536 JPAD patients, 27 patients were excluded for eGFR &lt;30ml/min/1.73m 2 on registration. BP of the JPAD patients was recorded on average 8 times. Based on the mean value of systolic BP (SBP), we divided the patients into three groups: a High BP Group (n=607, SBP≥140 mm Hg); a Moderate BP Group (n=989, 140&gt;SBP≥130 mm Hg); or a Low BP Group (n=913, SBP&lt;130 mm Hg). We compared the incidence of LSKD among the three groups. Results: The mean eGFR (ml/min/1.73m 2 ) was 75.1 in the High BP Group, 72.6 in the Moderate BP Group, and 75.7 in the Low BP Group on registration. During a 11.2-year follow-up, the incidence of LSKD was significantly higher in the High BP and Moderate BP Groups than in the Low BP Group (P&lt;0.0018, Figure). Cox proportional hazards model analysis revealed that the High BP (HR, 1.57, P=0.049) and Moderate BP (HR, 1.52, P=0.037) were independent factors after adjustment for proteinuria≥±, age≥65 years, men, body mass index≥24 kg/m 2 , duration of diabetes ≥7.0 years, statin usage, aspirin usage, eGFR≥60 ml/min/1.73m 2 , and hemoglobin A1c ≥7.2 % (Figure). Conclusions: Our study demonstrated that SBP was independently associated with the progression to LSKD in diabetic patients, without a history of atherosclerotic events. SBP less than 130 mm Hg is recommended for diabetic patients to prevent progression to LSKD.

Age-related changes in blood pressure and heart rates of patients with Parkinson's disease.

This study evaluated yearly changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rates (HR) for patients with Parkinson's disease (PD). Data were collected for the last 10 years from medical records of 28 PD patients and 30 non‐PD patients with other neurological disorders. Age‐related changes in each group were analyzed by year using mean values of SBP, DBP, and HR obtained at their bi‐monthly visits. In results, PD patients had a gradual decrease in SBP with longer disease duration, and mean SBP significantly decreased from Year 7–11 compared to the mean values for Year 1 (p < .001 or p < .01). In non‐PD patients, mean SBP significantly increased from Year 4–11 compared to the mean values for Year 1 (p < .001 or p < .01). This is the first study to report age‐related changes of BP in individual patients with PD over 10 years.