Systolic Blood Pressure Measurements Research Articles

Assessment and management of exaggerated blood pressure response to standing and orthostatic hypertension: consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability.

Recent evidence suggests that an exaggerated blood pressure (BP) response to standing (ERTS) is associated with an increased risk of adverse outcomes, both in young and old individuals. In addition, ERTS has been shown to be an independent predictor of masked hypertension. In the vast majority of studies reporting on the prognostic value of orthostatic hypertension (OHT), the definition was based only on systolic office BP measurements. This consensus statement provides recommendations on the assessment and management of individuals with ERTS and/or OHT. ERTS is defined as an orthostatic increase in SBP at least 20 mmHg and OHT as an ERTS with standing SBP at least 140 mmHg. This statement recommends a standardized methodology to assess ERTS, by considering body and arm position, and the number and timing of BP measurements. ERTS/OHT should be confirmed in a second visit, to account for its limited reproducibility. The second assessment should evaluate BP changes from the supine to the standing posture. Ambulatory BP monitoring is recommended in most individuals with ERTS/OHT, especially if they have high-normal seated office BP. Implementation of lifestyle changes and close follow-up are recommended in individuals with ERTS/OHT and normotensive seated office BP. Whether antihypertensive treatment should be administered in the latter is unknown. Hypertensive patients with ERTS/OHT should be managed as any other hypertensive patient. Standardized standing BP measurement should be implemented in future epidemiological and interventional studies.

Sex differences in cardiometabolic risk factors and in response to lifestyle intervention in prepubertal and pubertal subjects with obesity.

Childhood obesity is a growing health problem and requires a tailored treatment. This study explored the sex differences in cardiovascular risk factors in children/adolescents with obesity and in response to a weight loss intervention. Five hundred and thirty-three children/adolescents with obesity and their parents underwent to a 3-months lifestyle intervention program. Tanner criteria were used to assess the pubertal stage. Before and after 3 months, anthropometric measurements, blood pressure (BP), and biochemical measurements were assessed. Four hundred and forty five participants completed the treatment (age 12.4 ± 2.7 years, males 45.8%, prepubertal 29.2%, BMI z score 2.3 ± 0.2). In comparison to boys, prepubertal girls had higher values of BMI z score (2.4 ± 02 vs. 2.3 ± 0.2, p < 0.05), waist circumference z score (2.2 ± 0.3 vs. 2.0 ± 0.3, p < 0.05), HOMA-IR [2.9 (2.1-4.9) vs. 2.3(1.5-3.6), p < 0.01], prevalence of hypertransaminasemia (41.3% vs. 17.7%, p < 0.05) and lower levels of HDL cholesterol (46.2 ± 9.8 vs. 51.2 ± 10.5 mg/dl, p < 0.05). In the pubertal stage, boys had worse cardiometabolic risk profile than girls, including unfavourable measure of systolic BP (z score: 0.6 ± 1.0 vs. 0.3 ± 1.0, p < 0.01), fasting glucose (87.2 ± 6.1 vs. 84.8 ± 7.7 mg/dl, p < 0.01), ALT (26.9 ± 21.5 vs. 20.2 ± 10.6 U/L, p < 0.001) and uric acid (6.1 ± 1.9 vs. 5.0 ± 1.0 mg/dl, p < 0.001). After the lifestyle intervention, changes in BMI z score (p < 0.05) were higher in pubertal boys than pubertal girls. The systolic blood pressure decrease was greater in pubertal boys than in their female counterpart (Δ systolic BP: -7.2 mmHg in boys vs. -3.6 mmHg in girls, p < 0.05; Δ systolic BP z score: -0.6 in boys vs. -0.3 in girls, p < 0.05). LDL cholesterol showed an improvement only in boys, and ALT in the whole group. Our study showed that a short-term lifestyle intervention is more effective in reducing BMI z score and cardiovascular risk factors in pubertal boys than in their female counterparts. Further investigation is needed to deepen this gender difference, especially to develop a tailor-made intervention.

Arterial blood gas measurements are different for brachycephalic and nonbrachycephalic dogs acclimatized to an altitude of 1,535 meters.

To define reference intervals (RIs) for arterial blood gas (aBG) measurements in healthy, nonsedated, dolichocephalic, and mesocephalic (nonbrachycephalic) dogs at approximately 1,535 m above sea level and compare these findings with healthy, nonsedated, brachycephalic dogs living at the same altitude. 120 adult nonbrachycephalic dogs and 20 adult brachycephalic dogs. Cases were prospectively enrolled from October 2021 to June 2022. Dogs were enrolled from the community or after presentation for wellness examinations or minor injuries including lacerations, nail injuries, and lameness. Physical examinations and systolic blood pressure (sBP) measurements were obtained before blood sample collection. Arterial blood was collected from the dorsal pedal artery or femoral artery. After data collection, brachycephalic dogs underwent pre- and postexercise tolerance assessments. The mean and RI values for arterial pH (7.442; 7.375 to 7.515), partial pressure of oxygen in arterial blood (Pao2; 78.3; 59.2 to 92.7 mm Hg), partial pressure of carbon dioxide in arterial blood (Paco2; 28.0; 21.5 to 34.4 mm Hg), saturation of arterial oxygen (Sao2; 98.4; 84.3% to 101.4%), HCO3 (18.9; 14.9 to 22.4 mmol/L), concentration of total hemoglobin (ctHb; 17.5; 13.4 to 21.1 g/dL), and sBP (133; 94 to 180 mm Hg) were established for healthy nonbrachycephalic dogs at 1,535-m altitude. All aBG measurements were statistically and clinically different from those previously reported for dogs at sea level. Brachycephalic dogs had significantly lower Pao2 and Sao2 (P = .0150 and P = .0237, respectively) and significantly higher ctHb (P = .0396) compared to nonbrachycephalic dogs acclimatized to the same altitude; the nonbrachycephalic RIs were not transferable to the brachycephalic dogs for Pao2. This study represents the first collation of aBG measurements for healthy nonbrachycephalic dogs acclimatized to an altitude of 1,535 m. Additionally, this study identified differences in arterial oxygenation measurements between brachycephalic and nonbrachycephalic dogs. RIs in brachycephalic dogs need to be established.

Abstract 148: Increased Systolic Blood Pressure Variability During the First 24-hours of Hospitalization Associates With Poor 90-day Outcome After Intracerebral Hemorrhage

Introduction: Prospective studies and secondary analyses from clinical trials have identified increased systolic blood pressure variability (SBPV) as a risk factor for poor outcomes. Evidence of this association in real-world intracerebral hemorrhage (ICH) hospitalization is lacking, however. Methods: Data for adult (≥18) patients with primary ICH were retrieved from the REINAH cerebrovascular research database. Systolic blood pressure measurements from the first 24 hours of admission were retrieved and SBPV was calculated as the Coefficient of Variation (CV) = (standard deviation/mean)*100. Socioeconomic deprivation was assessed using the state Area Deprivation Index (ADI), with high deprivation assessed at ADI ≥ 8. The primary outcome was severe disability or death (SDD; modified Rankin Scale ≥4) at 90-days after discharge. Differences in SBPV across SDD were assessed using the Mann-Whitney U test. Associations between SBPV and SDD were assessed using multivariable logistic regression models adjusted for patient characteristics. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. Results: Final cohort included 807 patients (median [IQR]: 66 [54-77], 45.6% female), with an ethno-racial distribution of 41.9% White, 25.9% Black, 23.9% Hispanic, 5.7% Asian, and 2.6% Other. The median CV was 12.07 [9.50-15.59] and 485 (60.1%) patients experienced SDD. Patients with SDD showed significantly higher SBPV than non-SDD patients (12.90 [10.33-17.11] vs 10.99 [8.72-13.72]; p&lt;0.001). Patients with 24-hour SBPV in the 3 rd (1.86 [1.16-2.96]) and 4 th quartile (3.10 [1.89-5.09]) had higher independent odds of SDD (vs. 1 st quartile) (Figure 1). Discussion: Patients with high SBPV during the first 24 hours of admission have higher odds of severe disability or death at 90-days after discharge.

Comparison of Thames Medical CAT+ Doppler and SunTech Vet 20 oscillometric devices for non-invasive blood pressure measurement in conscious cats.

A comparative assessment of systolic blood pressure (BP) measurement agreement and precision in two commonly used non-invasive BP devices was carried out in conscious cats. Systolic BP measurements were obtained from 50 conscious cats as part of their clinical investigations. All measurements were taken by the same operator and were performed according to the American College of Veterinary Internal Medicine (ACVIM) consensus guidelines. The same cuff location and cuff size were used for paired measurements. The order of device use was randomised, and an arousal score was assigned during each procedure. Precision was assessed using standard deviation and coefficient of variance comparisons. Agreement was assessed using graphical and statistical comparisons of derived 'delta mean' and 'mean of means' data. A total of 50 cats aged between 3 months and 15 years were enrolled (29 domestic shorthair, seven domestic longhair, three British Shorthair, two Ragdoll, two Sphynx, two Persian, one Siamese, one Burmese, one Russian Blue, one Maine Coon and one Oriental) with a body weight in the range of 1.2-6.2 kg. BP measurements were in the range of 95-179 mmHg. Oscillometric measurements were associated with lower arousal scores. The Doppler device demonstrated superior repeatability precision. Body weight, sex, cuff size, cuff location, arousal score and the order in which the devices were used had no significant effect on precision or agreement. Correlation between the two devices was 0.0837 and agreement was considered clinically acceptable (<10 mmHg) in 32/50 (64%) cats. Of the 18 cats with suboptimal agreement, the oscillometric mean BP was higher in 14 (78%) cats. Based on this study sample, suboptimal agreement between paired CAT+ Doppler and SunTech Vet20 oscillometric BP measurements in 36% of conscious cats suggests that these devices should not be used interchangeably. Compared with Doppler, oscillometric measurements were consistently higher, particularly at higher blood pressures. Further studies are required to assess which device has superior accuracy in conscious cats.

Incidence and prevalence of hypertension among HIV-TB co-infected participants accessing treatment: A five-year prospective cohort analysis.

Hypertension is a leading risk factor for cardiovascular disease among people living with human immunodeficiency virus (PLWH). This study determined incidence and prevalence of hypertension among PLWH receiving antiretroviral therapy (ART). We prospectively followed-up 642 HIV and tuberculosis (TB) co-infected study participants from 2005-2013. We defined hypertension as two consecutive elevated systolic and/or diastolic blood pressure measurements above 139/89 mmHg or current use of antihypertensive therapy. Of 507 participants analyzed, 53% were women. Median [interquartile range (IQR)] age, body mass index (BMI), and CD4 count was 34 (28.0-40.0) years, 22.7 (20.5-25.4) kg/m2, and 145 (69.0-252.0) cells/mm3, respectively. Incidence [95% confidence interval (CI)] of both systolic and diastolic hypertension overall, in men, and in women over 40 years was 1.9 (1.4-2.6), 5.9 (3.6-9.6), and 5.0 (2.7-9.3) per 100 person-years (PY), respectively. Risk of developing hypertension was higher in men [(adjusted hazard ratio (aHR) 12.04, 95% CI: 4.35-33.32)] and women over 40 years (aHR 8.19, 95% CI 2.96-22.64), and in men below 40 years (aHR 2.79, 95% CI 0.95-8.23). Higher incidence rates of hypertension among older men and women accessing ART highlight opportunities to expand current integrated HIV-TB care models, to include cardiovascular disease risk screening and care to prevent premature death.

Prenatal Urban Environment and Blood Pressure Trajectories From Childhood to Early Adulthood

BackgroundPrenatal urban environmental exposures have been associated with blood pressure in children. The dynamic of these associations across childhood and later ages is unknown. ObjectivesThe purpose of this study was to assess associations of prenatal urban environmental exposures with blood pressure trajectories from childhood to early adulthood. MethodsRepeated measures of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were collected in up to 7,454 participants from a UK birth cohort. Prenatal urban exposures (n = 43) covered measures of noise, air pollution, built environment, natural spaces, traffic, meteorology, and food environment. An exposome-wide association study approach was used. Linear spline mixed-effects models were used to model associations of each exposure with trajectories of blood pressure. Replication was sought in 4 independent European cohorts (up to 9,261). ResultsIn discovery analyses, higher humidity was associated with a faster increase (mean yearly change in SBP for an interquartile range increase in humidity: 0.29 mm Hg/y, 95% CI: 0.20-0.39) and higher temperature with a slower increase (mean yearly change in SBP per interquartile range increase in temperature: −0.17 mm Hg/y, 95% CI: −0.28 to −0.07) in SBP in childhood. Higher levels of humidity and air pollution were associated with faster increase in DBP in childhood and slower increase in adolescence. There was little evidence of an association of other exposures with change in SBP or DBP. Results for humidity and temperature, but not for air pollution, were replicated in other cohorts. ConclusionsReplicated findings suggest that higher prenatal humidity and temperature could modulate blood pressure changes across childhood.

Blood Pressure Trajectories and Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke.

Data on systolic blood pressure (SBP) trajectories in the first 24 hours after endovascular thrombectomy (EVT) in acute ischemic stroke are limited. We sought to identify these trajectories and their relationship to outcomes. We combined individual-level data from 5 studies of patients with acute ischemic stroke who underwent EVT and had individual blood pressure values after the end of the procedure. We used group-based trajectory analysis to identify the number and shape of SBP trajectories post-EVT. We used mixed effects regression models to identify associations between trajectory groups and outcomes adjusting for potential confounders and reported the respective adjusted odds ratios (aORs) and common odds ratios. There were 2640 total patients with acute ischemic stroke included in the analysis. The most parsimonious model identified 4 distinct SBP trajectories, that is, general directional patterns after repeated SBP measurements: high, moderate-high, moderate, and low. Patients in the higher blood pressure trajectory groups were older, had a higher prevalence of vascular risk factors, presented with more severe stroke syndromes, and were less likely to achieve successful recanalization after the EVT. In the adjusted analyses, only patients in the high-SBP trajectory were found to have significantly higher odds of early neurological deterioration (aOR, 1.84 [95% CI, 1.20-2.82]), intracranial hemorrhage (aOR, 1.84 [95% CI, 1.31-2.59]), mortality (aOR, 1.75 [95% CI, 1.21-2.53), death or disability (aOR, 1.63 [95% CI, 1.15-2.31]), and worse functional outcomes (adjusted common odds ratio,1.92 [95% CI, 1.47-2.50]). Patients follow distinct SBP trajectories in the first 24 hours after an EVT. Persistently elevated SBP after the procedure is associated with unfavorable short-term and long-term outcomes.

The effect of educational intervention based on the PRECEDE-PROCEED model on self-care behaviors and quality of life of hypertensive patients.

To prevent the harmful consequences of hypertension and enhance the quality of life of hypertensive patients, the use of educational models is highly suggested. Therefore, the present study was designed to determine the effect of education based on the PRECEDE-PROCEED on self-care behaviors and the quality of life of hypertensive patients in Kazeroon city, Iran, in 2023. A total of 120 hypertensive individuals who were referred to Kazeroon city health centers participated in the current quasi-experimental study. The participants were divided into two experimental and control groups using a random sampling technique (60 participants in each group). The self-care behaviors questionnaire, the quality of life questionnaire, and a questionnaire based on the PRECEDE-PROCEED model were used as the data acquisition techniques. Both groups completed the questionnaires before and 2 months after the intervention. The educational program included a six-session, 50-60 min training program using three different teaching methods (speaking, Q&A, group discussion, and peer training) in health facilities. The data were examined using paired t, independent t, and chi-square statistical tests after being entered into the SPSS 24 statistical program. Following the intervention, the experimental group showed significantly higher values in quality of life, knowledge, attitude, enabling and reinforcing factors, and self-care behaviors compared to the control group (p < 0.001 for all comparisons). The experimental group also exhibited a significant reduction in systolic blood pressure measures compared to the control group (p < 0.001). In the present study, education based on the PRECEDE-PROCEED model and focusing on blood pressure self-care behavior in patients with hypertension led to a decrease in their systolic blood pressure measures and improved their quality of life.

Joint regression modeling of blood pressure and associated factors among adults in Uganda: Implications for clinical practice.

Blood pressure (BP) is a repeated measurement data as multiple measurements of both systolic blood pressure (SBP) and diastolic blood pressure (DBP) are simultaneously obtained on a patient to determine a raised blood pressure (hypertension). In examining factors associated with hypertension, BP is measured either as a binary outcome leading to information loss and reduced statistical efficiency or as a continuous outcome based on the average of one of the measurements or a combination of the two but independently thus ignoring possible correlation. We simultaneously modeled the risk factors for increased SBP and DBP among adults in Uganda and tested the difference in the effect of certain determinants on SBP versus DBP. We analyzed the 2014 nationwide non-communicable disease risk factor baseline survey data of Ugandans aged 18-69 years. We considered SBP and DBP as two continuous outcomes and conducted multivariate linear regression to jointly model SBP and DBP accounting for their distribution as bivariate normal. Of 3,646 participants, 950 (26.1%) had hypertension based on SBP (BP ≥ 140 mmHg) and DBP (BP ≥ 90 mmHg), 631 (17.3%) based on SBP alone, and 780 (21.4%) based on DBP alone. The study found that an increase in age (ranging from 18-69 years), obesity, income, being centrally obese, and hypercholesterolemia were significantly associated with higher SBP levels. Living in eastern, northern, and western Uganda regions was significantly associated with lower SBP, whereas increasing age, obesity, and hypercholesterolemia were significantly associated with higher DBP. Adults who rarely added salt to their meals were on average associated with higher DBP levels than those who never added salt to their meals. We found a strong residual correlation between SBP and DBP (r = 0.7307) even after accounting for covariates at the marginal level. This study presents a statistical technique for joint modeling of blood pressure, enabling the estimation of correlation between two outcomes and controlling family-wise error rate by testing the effect of a risk factor across both outcomes simultaneously.

Эффективность неонатального скрининга на критические врожденные пороки сердца путем двузонного измерения систолического артериального давления и сатурации

Aim. To evaluate screening methods for critical congenital heart defects (CHD), in particular obstructive aortic arch defects (OАADs), using dual-zone systolic blood pressure (SBP) and oxygen saturation measurements in healthy newborns. Design. A prospective observational study. Material and methods. The study included 12 098 healthy newborns aged 48 (36–50) hours of life, who were screened for critical CHDs using dual-zone measurements of SBP and saturation, as well as using physical methods. Screening for critical CHDs was considered normal if the saturation difference was 2% or less, the saturation was more than 95%, the difference in SBP was 9 mm Hg and less. If the screening was abnormal, echocardiography (ECHO-CG) was performed. The end point of the study was to determine the sensitivity and specificity of screening for OPAADs in healthy newborns using dual-zone measurement of SBP and saturation. Results. 12 037 children had normal screening results. In these children, the difference in pre- and postductal SBP was 0 (standard deviation (σ) = 4.26 mm Hg, and the difference (Me) in saturation was 0 (σ = 0.93%). Dual-zone SBP screening was abnormal in 34 newborns. The difference in their SBP was 11 (10–34) mm Hg. In 16 of these children ECHO-CG did not reveal CHD, and in 4 — critical OAADs — coarctation of aorta was diagnosed. A decrease in peripheral pulsation in the femoral arteries was noted only in children with critical OAADs. Pulse oximetry screening was normal in these children with critical OAADs. Dual-zone saturation screening was abnormal in 16 children. The difference in saturation between them was 3 (3–5)%. In 13 of these children, ECHO-CG did not reveal CHDs, and in 1 child critical CHD was diagnosed — transposition of the great arteries. Also, this child (and another who was healthy) had a decrease in saturation of less than 95%. In 11 newborns, screening was abnormal only due to saturation of 95% or less, but ECHO-CG did not reveal CHDs. The sensitivity and specificity of screening for OAADs using dual-zone SBP measurement was 100 and 80%, and using dual-zone pulse oximetry was 0 and 73.6%, respectively. Conclusions. In newborns with OAADs, a difference in SBP of 10 mmHg is recorded after 36 hours of their life. Dual-zone measurement of SBP is the most highly sensitive and specific method for detecting OAADs in comparison with dual-zone pulse oximetry. Dual-zone measurement of SBP and determination of peripheral pulsation are recommended for inclusion in the neonatal screening protocol for critical CHDs. Keywords: congenital heart disease, neonatal screening for congenital heart defects, aortic coarctation, aortic arch interruption, blood pressure.

Social network size moderates the association between loneliness and cardiovascular reactivity to acute stress

Loneliness and objective measures of social isolation (e.g., social network size) have been associated with increased risk of cardiovascular disease (CVD). However, the evidence is mixed and the precise causal mechanisms remain unclear. Cardiovascular reactivity (CVR) to acute stress has been posited as a proposed mechanism. This study aimed to investigate: (i) effects of loneliness and social isolation on CVR to stress and, (ii) whether the loneliness – CVR relationship was moderated by social network size. Two hundred and six participants from the Pittsburgh Cold Study underwent a modified version of the Trier Social Stress Task. Cardiovascular measures of systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were taken throughout the laboratory stress trial. Hierarchical regression analyses found that social network size was positively associated with DBP reactivity (β = 0.19 95 % CI [0.05, 0.29] p = 0.005), while loneliness was not. In addition, social network size moderated the loneliness - DBP reactivity relationship such that a higher number of outer social network ties were beneficial at lower levels of loneliness but not higher. The current study contributes new evidence linking loneliness and social network size to cardiovascular psychophysiology but raises questions about the loneliness - CVD relationship. The findings confirm the importance of social network size and highlight that the characteristics of the networks may be more important than the number of networks.

Renal biomarkers, clinical parameters, and renal Doppler velocimetry in bitches with cystic endometrial hyperplasia-pyometra complex.

Cystic endometrial hyperplasia (CEH)-pyometra complex is the most common uterine infection in adult and elderly bitches and can cause renal dysfunction. The aim of this study was to measure and compare urinary creatinine, urea, symmetric dimethylarginine (SDMA), urinary protein-creatinine ratio (UPC), measurement of systolic blood pressure (SBP), and Doppler velocimetry of renal arteries in patients with CEH-pyometra complex before and after an average of 6 months of treatment, evaluating the possibility of the changes persisting. The evaluation was conducted at two moments: M1 (at the diagnosis of CEH-pyometra, n = 36) and M2 (after an average of six months of treatment, n = 16). For the control group, eight bitches with no changes in blood tests or history of conditions underwent Doppler ultrasound evaluation of the renal arteries. At both M1 and M2, we measured creatinine, urea, and serum SDMA, UPC, SBP, and Doppler ultrasound of the renal arteries. Patients were evaluated according to the following groups: azotemic (AZO) and non-azotemic (NAZO), and open and closed cervix pyometra. The parameters were compared between animals present in both moments presented as M1R (bitches that were in M1 and M2) and M2. Statistical significance was considered when p < .05. The medians found for creatinine in M1 were as follows: 1.15 mg/dL, being 1.8 mg/dL for AZO (12/36) and 0.95 mg/dL for NAZO (24/36); and in M2: 0.85 mg/dL (16/16), being 1.15 mg/dL for AZO (4/16) and 0.8 mg/dL for NAZO (12/36). For urea, in M1 it was 36 mg/dL (32/36), with AZO being 103 mg/dL (11/32) and 33 mg/dL in NAZO (21/32); and in M2 32 mg/dL (16/ 16), being 29 mg/dL for AZO (4/36), and 31 mg/dL for NAZO (3/15). The median SDMA measured in M1R was 17 μg/dL (15/16), with AZO being 31 μg/dL (3/15), and NAZO being 16.5 μg/dL (12/15); and in M2, SDMA was 12 μg/dL (16/16), with AZO being 12.5 μg/dL (4/16), and NAZO being 12 μg/dL (12/16). The median UPC measured in M1 was 1.15 (10/36), with AZO being 0.25 (1/10), and NAZO being 1.38 (9/10); and in M2, it was 0.2 (13/16), being 0.1 in AZO (4/13), and 0.2 (9/16) in NAZO. For SBP, in M1, it was 118 mmHg (30/36), with AZO being 102 mmHg (10/30) and 133 mmHg in NAZO (20/30); and in M2 142.5 mmHg (12/16), being 155 mmHg for AZO (4/12), and 140 mg/dL for NAZO (8/12). When comparing animals with open and closed cervixes, a difference was found between SDMA measurements (p = .001). There was a distinction between PI and RI of the left and right kidneys consecutively (p = .007; p = .033; p = .019; p = .041). Correlations found in M1: SDMA × PI RIM DIR (r = 0.873; p = .002), SDMA × PSV RIM ESQ (r = 0.840; p = .004), SDMA × EDV RIM ESQ (r = 0.675; p = .046). With this study, we conclude a return to normality of renal biomarkers and clinical parameters after six months. Yet, there is a persistence of Doppler velocimetric measurements between the two moments. Thus, this parameter is not suitable for identifying and classifying chronic kidney injury in bitches with pyometra.

AGE-SPECIFIC POPULATION ATTRIBUTABLE FRACTIONS FOR THE IMPACT OF HYPERTENSION ON INCIDENT DEMENTIA

Abstract The population attributable fraction (PAF) of dementia in United States attributable to hypertension is estimated at 7-9%. However, prior studies of the PAF might underestimate hypertension’s impact on dementia risk, given specific design limitations. Additionally, prior work neither accounted for changing prevalence/effects of hypertension with age nor considered early vs. later occurring dementia. Here, we quantified PAFs of dementia by age 80 from hypertension measured at midlife and late-life using individual-level data from the Atherosclerosis Risk in Communities Study. Incident dementia was determined by adjudicated review, telephone interviews, informant interviews, hospitalization records, and death certificates. We used measures of systolic and diastolic blood pressure (SBP, DBP) to define BP categories: normal BP (SBP &amp;lt; 120 and DBP &amp;lt; 80), elevated BP (SBP 120-129 and DBP &amp;lt; 80), stage 1 hypertension (SBP 130-139 or DBP 80-89), and stage 2 hypertension (SBP ≥140 or DBP ≥90); we also defined an overall non-normal BP value (SBP ≥120 or DBP ≥80). We generated hazard ratios (HRs) of 32-year incident dementia from Cox regression models that adjusted for demographic and clinical characteristics, and stratified by age at BP ascertainment (45-54, 55-64, 65-74). We then used the HRs to quantify PAFs of dementia from hypertension. We estimated that 15-20% of dementia cases by age 80 were attributable to non-normal BP. The strongest PAFs (12-21%) were from stage 2 hypertension. Current estimates of the dementia risk attributable to hypertension may be low. Targeting hypertension from midlife through early late-life could sizably reduce dementia risk.

Pengaruh pemberian bubuk susu kacang hijau terhadap tekanan darah dan denyut nadi pasca pemulihan atlet sepakbola

Background: Resistance exercise can cause microdamage to muscle tissue, leading to more severe damage over time. In particular, athletes who tend to exercise with moderate to heavy intensity are at a high risk of injury and have a longer recovery due to excessive fatigue during exercise. A proper nutritional strategy is needed to reduce the effects of exercise and accelerate recovery by supplementation with amino acids (BCAA). BCAAs are a branch-chain amino acid series of leucine, lysine, and isoleucine. Green beans are foods high in amino acids, such as lysine, valine, isoleucine, cysteine, methionine, and tryptophan.Objectives: This study aimed to investigate the effect of green bean milk powder on post-recovery blood pressure and pulse rate in football athletes.Method: The research used a quasi-experimental approach with a one-group pre-posttest control group design. The subjects in this study were 22 football athletes at BPPLOP Central Java, conducted in May 2023. The markers used in this study were post-recovery blood pressure and pulse rate. Blood pressure and pulse measurements were performed using the oscillometric method by placing the cuff on the upper arm, and the measurement results were observed on the monitor connected to the cuff on the Omron® digital tensimeter. Data were analyzed using an Independent Sample T-Test and Mann-Whitney U test at 95% CI.Results: Both groups of subjects in this study consisted of ages ranging from 15-19 years, body weight between 52-72 kg, height between 165-178 cm, nutritional status between normal-fat, percent body fat in the normal category, energy intake, carbohydrates, protein, and fat. At the same time, the energy and nutrient intake analysis results in each group showed that the subjects’ energy intake was still in the deficit or deficient group. In contrast, fat intake in each group was classified as excess. There was no significant difference in the provision of mung bean milk powder intervention before and after stages 1 and 2 of the study on the results of systolic blood pressure measurements (p= 0,844), diastolic blood pressure (p= 0,115) and post-recovery pulse rate (p= 0,972).Summary: Giving green bean milk powder at 25 g/day after exercising for eight days did not significantly affect blood pressure or post-recovery pulse rate.

Hypoglossal Nerve Stimulation and Cardiovascular Outcomes for Patients With Obstructive Sleep Apnea

Sham-controlled trials are needed to characterize the effect of hypoglossal nerve stimulation (HGNS) therapy on cardiovascular end points in patients with moderate-severe obstructive sleep apnea (OSA). To determine the effect of therapeutic levels of HGNS, compared to sham levels, on blood pressure, sympathetic activity, and vascular function. This double-blind, sham-controlled, randomized crossover therapy trial was conducted from 2018 to 2022 at 3 separate academic medical centers. Adult patients with OSA who already had an HGNS device implanted and were adherent and clinically optimized to HGNS therapy were included. Participants who had fallen asleep while driving within 1 year prior to HGNS implantation were excluded from the trial. Data analysis was performed from January to September 2022. Participants underwent a 4-week period of active HGNS therapy and a 4-week period of sham HGNS therapy in a randomized order. Each 4-week period concluded with collection of 24-hour ambulatory blood pressure monitoring (ABPM), pre-ejection period (PEP), and flow-mediated dilation (FMD) values. The change in mean 24-hour systolic blood pressure was the primary outcome, with other ABPM end points exploratory, and PEP and FMD were cosecondary end points. Participants (n = 60) were older (mean [SD] age, 67.3 [9.9] years), overweight (mean [SD] body mass index, calculated as weight in kilograms divided by height in meters squared, 28.7 [4.6]), predominantly male (38 [63%]), and had severe OSA at baseline (mean [SD] apnea-hypopnea index, 33.1 [14.9] events/h). There were no differences observed between active and sham therapy in 24-hour systolic blood pressure (mean change on active therapy, -0.18 [95% CI, -2.21 to 1.84] mm Hg), PEP (mean change on active therapy, 0.11 [95% CI, -5.43 to 5.66] milliseconds), or FMD (mean change on active therapy, -0.17% [95% CI, -1.88% to 1.54%]). Larger differences between active and sham therapy were observed in a per-protocol analysis set (n = 20) defined as experiencing at least a 50% reduction in apnea-hypopnea index between sham and active treatment. In this sham-controlled HGNS randomized clinical trial, mean 24-hour systolic blood pressure and other cardiovascular measures were not significantly different between sham and active HGNS therapy. Several methodologic lessons can be gleaned to inform future HGNS randomized clinical trials. ClinicalTrials.gov Identifier: NCT03359096.

Bayesian longitudinal modeling of blood pressure measurements of hypertensive patients at Wachemo University Nigist Elleni Mohamed Memorial Teaching and Referral Hospital Hosanna, Southern Ethiopia

Hypertension is characterized by the persistent elevation of blood pressure (BP) above the normal range or the use of antihypertensive medication. It represents a major global health issue and serves as a significant risk factor for conditions such as stroke, myocardial infarction, vascular disease, and chronic kidney disease. This study aimed to model the longitudinal measurements of diastolic blood pressure and systolic blood pressure in hypertensive patients using a Bayesian approach. The data were obtained from the records of Wachemo University Nigist Elleni Mohamed Memorial Teaching and Referral Hospital. It encompassed the basic demographic and clinical characteristics of 200 hypertensive patients who commenced antihypertensive treatment between September 2015 and March 2020. Descriptive analysis and a Linear mixed-effects model were employed to analyze the data, utilizing the Bayesian approach with the JMbayes package in R software. The results of this study revealed significant associations between age, time, family history, related diseases, and the mean change of systolic blood pressure (SBP) measurements within the bivariate linear mixed model. Likewise, time, residence, related diseases, and the interaction of time with sex and diabetes demonstrated a significant effect on the mean change of diastolic blood pressure (DBP) measurements in antihypertensive patients. By employing a bivariate linear mixed model, an association of 0.8565 was observed between the evolution (AE) of SBP and DBP. Based on the study findings, we can summarize that age, time, family history, and related diseases have a significant impact on the mean change of SBP, while time, residence, related diseases, and the interaction of time with sex and diabetes affect the mean change of DBP. Furthermore, a strong association exists between the evolution of SBP and DBP.

Digital Sphygmomanometer Detects Systole Diastolic Display

Hypertension. characterized by elevated blood pressure against artery walls. can be influenced by a patient's body temperature. Therefore. detecting body temperature before measuring blood pressure is essential for accurate assessment. Currently. Digital Tension and Body Temperature parameters are typically evaluated separately. To address this. we propose a novel approach to combine these parameters into a single unit. enhancing health monitoring. Utilizing MPX5050GP for blood pressure and MLX90614 for body temperature detection. Both sensors are directly connected to the Arduino UNO microcontroller. enabling seamless data processing and display on the Nextion LCD. Experimental results demonstrate the device's effectiveness. with systolic blood pressure measurements showing a Maximum error: 2.23%. minimum error: 0.53% for systolic measurements. Diastolic measurements have with a remarkable maximum error of only 4.69% and a minimal error of 1.79%. Additionally. the body temperature measurements exhibited a Achieved exceptional precision with errors as low as 0.45% and a maximum of 1.65%. Successfully completed. this design facilitates simultaneous measurement of two vital parameters. Its potential to streamline health monitoring could significantly impact hypertension management and other related conditions. Further validation and implementation in clinical settings are anticipated to enhance its utility and benefits.

Effect of Dietary Sodium on Blood Pressure

Dietary sodium recommendations are debated partly due to variable blood pressure (BP) response to sodium intake. Furthermore, the BP effect of dietary sodium among individuals taking antihypertensive medications is understudied. To examine the distribution of within-individual BP response to dietary sodium, the difference in BP between individuals allocated to consume a high- or low-sodium diet first, and whether these varied according to baseline BP and antihypertensive medication use. Prospectively allocated diet order with crossover in community-based participants enrolled between April 2021 and February 2023 in 2 US cities. A total of 213 individuals aged 50 to 75 years, including those with normotension (25%), controlled hypertension (20%), uncontrolled hypertension (31%), and untreated hypertension (25%), attended a baseline visit while consuming their usual diet, then completed 1-week high- and low-sodium diets. High-sodium (approximately 2200 mg sodium added daily to usual diet) and low-sodium (approximately 500 mg daily total) diets. Average 24-hour ambulatory systolic and diastolic BP, mean arterial pressure, and pulse pressure. Among the 213 participants who completed both high- and low-sodium diet visits, the median age was 61 years, 65% were female and 64% were Black. While consuming usual, high-sodium, and low-sodium diets, participants' median systolic BP measures were 125, 126, and 119 mm Hg, respectively. The median within-individual change in mean arterial pressure between high- and low-sodium diets was 4 mm Hg (IQR, 0-8 mm Hg; P < .001), which did not significantly differ by hypertension status. Compared with the high-sodium diet, the low-sodium diet induced a decline in mean arterial pressure in 73.4% of individuals. The commonly used threshold of a 5 mm Hg or greater decline in mean arterial pressure between a high-sodium and a low-sodium diet classified 46% of individuals as "salt sensitive." At the end of the first dietary intervention week, the mean systolic BP difference between individuals allocated to a high-sodium vs a low-sodium diet was 8 mm Hg (95% CI, 4-11 mm Hg; P < .001), which was mostly similar across subgroups of age, sex, race, hypertension, baseline BP, diabetes, and body mass index. Adverse events were mild, reported by 9.9% and 8.0% of individuals while consuming the high- and low-sodium diets, respectively. Dietary sodium reduction significantly lowered BP in the majority of middle-aged to elderly adults. The decline in BP from a high- to low-sodium diet was independent of hypertension status and antihypertensive medication use, was generally consistent across subgroups, and did not result in excess adverse events. ClinicalTrials.gov Identifier: NCT04258332.

Validation of a novel cuffless photoplethysmography-based wristband for measuring blood pressure according to the regulatory standard

Abstract Background Blood pressure is a key paramater in acute and chronic cardiovascular diseases (CVD) [1]. However, obtaining reliable and reproducible cuff blood pressure (BP) measurements is challenging. We demonstrate that a wristband-based PPG measurement in combination with a custom developed BP algorithm represents a possible alternative to cuff BP measurements. Purpose This study aimed to validate a novel cuffless photopletysmography (PPG)-based non-invasive wristband for continuous BP monitoring in accordance with ISO 81060-2:2019. Methods The study compared PPG-guided BP algorithm predictions with subclavian arterial reference measurements taken during cardiac catheterization. Eligible patients were consecutively included, and eligibility was screened following ISO 81060-2:2019 requirements. Reference measurements were performed using a validated invasive BP monitoring device with a sampling rate of 100Hz. PPG signals were collected using six light emission diodes and two photodiodes at a sampling rate of 128Hz. Three sequential initialization measurements were taken using a validated blood pressure cuff before the cardiac catheterization exam. These measurements, along with approximately 100 additional features (PPG-derived and based on patient demographics), were used as input for the machine learning-based BP algorithm. Correlation, mean error, and standard deviation (SD) were determined for systolic and diastolic BP measurements between the BP algorithm predictions and invasive reference measurements Results The study included 97 patients from whom 420 individual 30-second samples were obtained. The mean age, weight, and height of the analysed subjects were 67.1 (SD 11.1), 83.4 (SD 16.1), and 174.1 (SD 10.0), respectively. In 48 samples (11%), systolic BP was ≤100mmHg, while in 106 samples (25%), systolic BP was ≥160mmHg. Diastolic BP was ≤70 mmHg in 222 samples (53%) and ≥85 mmHg in 99 samples (24%). The BP algorithm predictions showed a high correlation with invasive reference measurements for systolic (r = 0.985) and diastolic (r = 0.961) BP measurements. The mean error of the BP algorithm predictions compared to the invasive reference measurements was ±3.7 mmHg (SD 4.4 mmHg) and ±2.5 mmHg (SD 3.7 mmHg) for systolic and diastolic BP, respectively. Results were similar within each gender and skin colour category (Fitzpatrick I-VI). Conclusion This study demonstrates that a wristband-based PPG measurement in combination with the developed BP algorithm can provide accurate continuous BP measurements across a wide range of BP distributions. Therefore, wristband BP monitoring may serve as a valid and less burdensome alternative to cuff BP measurements for both in-hospital and at-home BP monitoring. However, further research is necessary to evaluate the precision of the BP algorithm during movement and the stability of the predictions over time.figure of BP