Reduce Blood Pressure Levels Research Articles

High Blood Pressure and Impaired Brain Health: Investigating the Neuroprotective Potential of Magnesium.

High blood pressure (BP) is a significant contributor to the disease burden globally and is emerging as an important cause of morbidity and mortality in the young as well as the old. The well-established impact of high BP on neurodegeneration, cognitive impairment, and dementia is widely acknowledged. However, the influence of BP across its full range remains unclear. This review aims to explore in more detail the effects of BP levels on neurodegeneration, cognitive function, and dementia. Moreover, given the pressing need to identify strategies to reduce BP levels, particular attention is placed on reviewing the role of magnesium (Mg) in ageing and its capacity to lower BP levels, and therefore potentially promote brain health. Overall, the review aims to provide a comprehensive synthesis of the evidence linking BP, Mg and brain health. It is hoped that these insights will inform the development of cost-effective and scalable interventions to protect brain health in the ageing population.

The impact of salt consumption on cardiometabolic and cognitive health in aged female rats

Health concerns about excess dietary salt have traditionally focused on its relationship with hypertension and the increased risk of cognitive impairment. However, research has often overlooked the unique health concerns and physiological differences between men and women, leading to gaps in knowledge, particularly regarding disease prevention and treatment strategies for women. The present study examined aged female rats over 12 weeks, using control, low, and high salt diets to mimic the post-menopausal phase in human females when cardiovascular risks typically increase. Cardiometabolic parameters and cognition were monitored. The findings revealed the impact of varying salt diets on blood lipids, blood pressure (BP) and heart rate (HR) levels and variability, anxiety, and cognition. Specifically, intake of a low-salt diet led to a significant reduction in BP levels but an increase in BP variability starting from the eighth week of the diet onset. Moreover, HR levels and variability were notably higher with the low-salt diet. Aged female rats exhibited increased anxiety on the low-salt diet at the fourth week, but the anxiety began to improve starting from the eighth week. Additionally, a trend suggested that the low salt intake worsened short-term memory while improving long-term memory. Furthermore, plasma lipids decreased significantly in aged female rats on a high-salt diet compared to those on a low-salt diet. The study provides valuable insights into the effects of salt intake on cardiometabolic parameters and cognitive function in aged female rats, highlighting the importance of considering sex-specific dietary guidelines for cardiometabolic and cognitive health.

P032 THE IMPACT OF NATURE IMMERSION THERAPY ON BLOOD PRESSURE IN HYPERTENSIVE SUBJECTS: A PILOT STUDY

Background and Objective: Conscious nature immersion therapy, termed “Vitamin N”, has shown promise in reducing blood pressure levels in individuals with or without hypertension. This pilot study aims to assess the effect of nature immersion on blood pressure specifically in hypertensive subjects. Methods: A convenience sample of stable hypertensive individuals participated in a standardized 3-hour nature immersion session. Systolic and diastolic blood pressure levels were recorded before the intervention (Phase I), after 30 minutes of the intervention (Phase II), and 48 hours post-intervention (Phase III). Statistical analysis employed a one-way non-parametric ANOVA, Kruskal-Wallis test, and Dunn's post hoc test, with a bilateral significance level of 95%. A criterion of at least 3 mmHg reduction in blood pressure was set for clinical significance. Results Eighteen participants, comprising 12 women (64.67%) and 6 men (33.33%), with a mean age of 60±9.04 years and 61±6.88 years, respectively, were included. Six individuals had a medical history of Diabetes Mellitus Type 2, and one had a history of coronary heart disease. Significant differences in median systolic (MSP) and diastolic pressures (MDP) were observed across the three phases (p<0.05). Notably, Phase II and Phase III showed consistent reductions in blood pressure compared to Phase I, exceeding the established 3 mmHg reduction criterion. Conclusions: Conscious nature immersion therapy (“Vitamin N”) exhibited a significant effect in lowering both systolic and diastolic blood pressure levels among hypertensive individuals. These findings suggest the potential of nature immersion as a non-pharmacological intervention for managing hypertension.

The effect of a self-management programme on blood pressure levels among people with hypertension: a randomised controlled trial.

Hypertension (HT) progression and complications depend on blood pressure levels. Managing blood pressure can reduce complications, increase well-being and improve quality of life. The study examined how an app-based self-management programme affected HT patients' blood pressure. The Police General Hospital in Thailand employed a randomised controlled trial design between June 2022 and June 2023. Forty-eight people were randomly split into two groups using permuted blocks: the control group (n = 24) and the experimental group (n = 24). The experimental group monitored their blood pressure for 4 weeks using a combination of apps and the phone, whereas the control group received standard care. The information was gathered by measuring blood pressure. Descriptive statistics and t-tests for independence were employed to analyse the data. The independent t-test results revealed a statistically significant reduction in the systolic blood pressure levels of the experimental group after the intervention (t = 2.945, df = 46, p = 0.005). However, no significant decrease was observed in the diastolic blood pressure levels of the experimental group after the intervention (t = 0.877, df = 46, p = 0.385). This study provides evidence for the effectiveness of a self-management programme utilising a mobile application in reducing blood pressure levels.

Study of thermally induced interactions between active substances from the sartans class and various excipients

AbstractSartans, also known as angiotensin receptor blockers, comprise a category of antihypertensive medications designed to inhibit the actions of angiotensin II (Ang II) in the body, ultimately reducing blood pressure levels. This class of compounds is derived from 2-(1-benzyl-1H-imidazol-5-yl)-acetic acid, with its origin characterized by an imidazole core that underwent various substitutions at specific positions within the heterocyclic nucleus. We investigated the behavior of Losartan, Valsartan and Irbesartan and their compatibility with various excipients used in pharmaceutical tablet formulations by FTIR spectroscopic studies, thermal behavior by thermogravimetry and differential scanning calorimetry. The aim of the study was to determine the excipients to be used in pharmaceutical formulations containing drugs from the class of sartans as active ingredients. Our study concludes by recommending precautionary measures in elaborating new solid formulations containing lactose in the case of Losartan.

Efficacy of renal denervation as an adjunct to pulmonary vein isolation for atrial fibrillation treatment: a systematic review and meta-analysis.

Catheter ablation, consisting of pulmonary vein isolation (PVI), is the most effective treatment modality for the management of symptomatic patients with atrial fibrillation (AF). Unfortunately, this procedure has a considerable relapse rate, ranging from 15 to 50% depending on AF type and other patient factors. Hypertension (HTN) is associated with a higher risk of developing AF and can also be managed with a catheter-based procedure-renal denervation (RDN). This meta-analysis aimed to compare the effect of PVI with and without RDN in hypertensive patients with AF. OVID MEDLINE and Embase were searched on 1 February 2023 and trials that reported the effects of RDN on AF recurrence in hypertensive patients were included. A total of 637 patients across 8 randomised controlled trials were included. The results from the pooled analysis showed that when compared with PVI alone, RDN added to PVI: (1) Lowered AF recurrence [RR 0.67 (0.53, 0.85), P = 0.001, I 2 = 23%, NNT = 5.9 patients]; (2) Reduced both systolic blood pressure and diastolic blood pressure, with medium effect size, as reflected by standardised mean differences of 0.5 (P = 0.02, I 2 = 80%) and 0.43 (P = 0.006, I 2 = 60%), respectively; and (3) was not associated with a decrease in estimated glomerular filtration rate (+7.19 mL/min/1.73 m2, P = 0.15, I 2 = 89%). Adding RDN to PVI in patients with AF and resistant HTN was associated with a reduction of blood pressure levels and AF recurrence. Consideration to RDN should be given as an adjunctive treatment for patients with AF and resistant HTN.

Exploring the Link between Seafood and Traditional Fish Sauces, and Blood Pressure: A Bandar Kong Cohort Study

Background: High blood pressure (BP) is a risk factor for various health conditions, and dietary factors have been linked to the development of high blood pressure. Scientific studies have shown that consuming marine food, particularly oily fish, can be beneficial in reducing blood pressure levels. This study aims to investigate the relationship between traditional fish sauces and seafood consumption, and blood pressure levels in Bandar Kong Cohort study. Methods: Cross-sectional analyses were performed using data from 2823 volunteers, collected through questionnaires and BP measurements following a standardized protocol. Age-adjusted and multivariate associations between BP and seafood consumption were estimated using multiple linear regressions. Three models of analysis were used: model 1, daily energy intake; model 2, daily energy intake along with age; and model 3, daily energy intake, age, education, body mass index (BMI), residence, occupation, marital status, using hookah, socio-economic status, physical activity, and family history of hypertension. Results: Among 2823 participants (age; 46.88±8.94 yrs.), 1138(40.3%) men and 1685(59.7%) women, 693 (24.5%) individuals had hypertension, (n=288) accounting for 25.3% men and (n=405) 24.0% women. After adjusting for covariates, the study found significant negative relationships between the consumption of salted fish-water, Mahyaveh and Suragh (traditional Iranian fish sauces), and BP. Conclusions: This study suggests that consuming traditional Iranian fish sauces, Mahyaveh and Suragh, is associated with lower BP levels. This study sheds light on potential benefits of traditional dietary choices for regulating blood pressure.

Egg white hydrolysate modulates the renin-angiotensin system in mesenteric perivascular adipose tissue in doca-salt hypertensive rats and restores its anticontractile ability

Perivascular adipose tissue (PVAT) regulates vascular tonus with an anticontractile effect, which may be dysfunctional in hypertension. An Egg White Hydrolysate (EWH), a bioactive food, restores endothelium dysfunction and reduces blood pressure levels in malignant hypertension. We aimed to evaluate whether dietary supplementation with EWH interferes with the PVAT function in the mesenteric resistance arteries (MRA) of DOCA-salt hypertensive animals and the mechanisms involved. Male rats were divided into 4 groups and treated for 8 weeks. For 4 weeks, DOCA-salt or vehicle-treated rats (SHAM) were induced, and after that, some rats were co-treated with DOCA-salt or vehicle plus EWH (1 g/kg/day) for 4 weeks more. MRA and/or their PVAT (mPVAT) were used for functional, molecular, and biochemical analysis. The anticontractile effect of mPVAT in response to norepinephrine (NE) was observed only in MRA rings with PVAT of the SHAM group, while this effect was abolished in DOCA-salt rings. The EWH treatment did not change the anticontractile effect of mPVAT in SHAM but partially restored it in DOCA-salt rats. Acute aliskiren incubation reduced NE-induced contraction only in MRA with PVAT of DOCA-salt rats. EWH prevented the overactivation of the renin levels and ACE activity in mPVAT of DOCA-salt rats; while did not change AT1R expression, but increased AT2R expression. In mPVAT, EWH blocked the increase of MDA, ROS and pro-inflammatory cytokines observed in DOCA-salt rats. EWH improved PVAT dysfunction in MRA of severe hypertension. This beneficial effect could be mediated by an ameliorated redox balance, inflammatory state, and RAS axis.

Prevalence of High Blood Pressure, Risks Factors, and Knowledge Deficit in Apparently Healthy College Students

Background: College students are assumed to be generally healthy, thus, elevated blood pressure can be easily missed in this population. However, recent research on college students has demonstrated increasing rates of elevated blood pressure. Situations that increase risk of elevated BP include higher levels of stress related to college education as well as other common stress producing events in life. Additionally, college students may engage in behaviors that increase risk such as eating poor diets, drinking alcohol, and not exercising regularly. The purpose of this study was to assess the prevalence of elevated blood pressure and risk factors in undergraduate college students and develop a campus wide educational initiative. Methods: Undergraduate students at a faith-based, Midwestern university (n = 138) participated in a cross-sectional study. Demographic data, standardized BP measurements, risk factors, and perceived stress levels were collected via a Google form and in-person assessments. Results: Fifty-two percent of college students had an elevated systolic blood pressure, and 30% had elevated diastolic blood pressure. Male students had significantly higher systolic (X2 = 101.343, p = .005) and diastolic blood pressure readings (X2 = 144.44, p < .001) compared to female students. There was no association between year in school and stress levels (X2 = 315.83, p = .102). Stress and systolic blood pressure were not correlated (r = .121, p = .180) nor were stress and diastolic blood pressure (r = .075, p = .408). Following the educational initiative, 96% of students (n = 91) were able to accurately define elevated blood pressure, risk factors for hypertension, and strategies to lower blood pressure. Conclusions: It is vital that blood pressure assessments become a priority for college students. These assessments must be followed by interventions aimed at reducing blood pressure levels, stress, and risk factors related to hypertension to prevent the long-term effects of cardiovascular disease. Healthcare providers on college campuses, including and perhaps most effectively students in health-related fields, should be involved in working with this population to increase awareness and screening efforts.

Treatment and Clinical Study of Hypertensive Patients

Objective: This study aims to investigate the treatment and clinical effect of hypertensive patients, and to compare the differences between personalized treatment and conventional treatment. Methods: 100 hypertensive patients from August 2022 to April 2023 were randomly sampled and equally divided into observation and control groups. The control group received traditional conventional therapy, and the observation group received personalized treatment. Statistical analysis of the data was performed using SPSS22.0. Results: The observation group showed advantages in drug use, changes in blood pressure level, incidence of drug side effects, mood control and medication compliance. The medication effect in the observation group was significantly better than the control group, with a large reduction in blood pressure levels and a relatively low incidence of drug side effects. Emotional control rate and medication compliance were also higher in the observation group. Conclusion: Personalized treatment is important for hypertensive patients. Through the individualized treatment plan, the treatment effect and the quality of life of the patients can be effectively improved. Therefore, in the treatment of hypertension, the individual differences of patients should be fully considered, and personalized treatment plans should be developed to achieve better treatment results.

Meta-analysis of experimental studies of the effect of melatonin monotherapy on hemodynamic parameters in normotensive and hypertensive rats

Objective. The purpose of the work is to use a meta-analysis to investigate the effect of melatonin monotherapy on the hemodynamic parameters of normotensive and hypertensive rats.Design and methods. For our metaanalysis, we selected 39 publications, of which 28 studied the effect of melatonin monotherapy on hemodynamic parameters in normotensive rats, 12 in SHR rats, 7 in rats with fructose-induced hypertension, 3 in rats with L-NAME-induced hypertension. Meta-analysis of study results was conducted using the statistical program Review Manager 5.3 (Cochrane Library).Results. Our meta-analysis showed that melatonin has a dose-dependent hypotensive and bradycardic effect with a single intravenous administration. The hypotensive effect of chronic administration of melatonin will increase with the duration of therapy. Moreover, the hypotensive effect of melatonin is significantly higher in hypertensive animals compared to normotensive ones. Long-term therapy with melatonin reduced blood pressure levels in normotensive animals by no more than 2 mm Hg, and in hypertensive rats by an average of 20–30 mm Hg.Conclusions. As a result, since melatonin demonstrates a good hypotensive effect in various models of experimental hypertension, it is advisable to continue clinical studies of the possibility of using melatonin in the treatment of hypertension, which should focus on monotherapy, dose selection, various methods of increasing bioavailability and prolonging the effect.

The Effect of Relaxation and Slow Breathing Technique (RSBT) as A Non-Pharmacological Intervention on Blood Pressure Level Among Stage 1 Hypertensive Older Adults

The prevalence of hypertension is relatively high, and the number still increases by year. Various studies have demonstrated that non-pharmacological methods have been shown capable of lowering blood pressure such as relaxation techniques, and also slow breathing technique. This study aims to determine the effects of relaxation and slow breathing technique (RSBT) on blood pressure level among stage 1 hypertensive older adults. This study utilized quantitative research method and the research design employed in this study is the one group interrupted time series pre-test post-test quasi-experimental design. Two types of instruments were used in this study to gather the pertinent data and information. The researcher utilized the checklist form to record the result of observation. The researcher also utilized biophysiologic instrument to measure to measure the blood pressure level of the participants. The participants of the study were ten (10) male and ten (10) female older adults with stage 1 hypertension who were selected through purposive sampling technique. Repeated-Measures ANOVA and the Post Hoc test was utilizing series of t-test. The result shows that there is a significant difference in the systolic and diastolic blood pressure level among participants before and after the implementation of the RSBT in both initial phase (first week) and reinstituted phase (third week). Prolonging of implementation of RBST would be more powerful to reduce blood pressure level among older adult with stage I hypertension.

YOGA TRAINING TO LOWER BLOOD PRESSURE ELDERLY IN SENGGRENG VILLAGE, MALANG REGENCY

Introduction: Diseases commonly observed in the elderly population are attributed to the decline in vascular functionality, with hypertension, also known as high blood pressure, being one such condition. The objective of this community service initiative is to assist senior citizens and elderly individuals in enhancing their knowledge regarding methods to reduce blood pressure levels. Additionally, it aims to enhance their proficiency in performing yoga exercises that have a positive influence on blood pressure.
 Method: The population in this community service activity is elderly people who are active in participating in activities organized by Posyandu Kromolio Pos 3 or Usila Mandiri Elderly School in Senggreng Village, Malang Regency. The sampling technique used is saturated sample technique or non-probability sampling. The older individuals will monitor their blood pressure during each gathering. The blood pressure assessment is conducted both prior to and following the implementation of yoga activities in order to ascertain the impact of those exercises on the blood pressure levels of older individuals.
 Results: At the first meeting, 58% of the elderly who attended experienced a decrease in blood pressure after doing yoga exercises. At the second meeting, 73% of the elderly who came experienced a decrease in blood pressure and 12% of the elderly did not experience changes in blood pressure before and after yoga exercises.
 Conclusion: Following the implementation of yoga activities as a form of treatment, a significant reduction in blood pressure was observed among the majority of senior individuals. Consequently, empirical evidence supports the assertion that yoga workouts yield beneficial effects in reducing hypertension among older individuals.
 Keywords: Community; health; hypertension; yoga; elderly

The therapeutic effects of fermented milk with lactic acid bacteria from traditional Daqu on hypertensive mice

Lactic acid bacteria (LAB), a type of microorganism widely used in functional foods, has gained notable research attention in recent years. Certain strains possess the proteolytic ability to release potentially antihypertensive peptides from dairy proteins, which prompted us to explore the LAB strains from an understudied and unique ingredient, Daqu. We screened for 67 strains of LAB strains from traditional Daqu using the calcium dissolution ring method. Sixteen strains exhibiting angiotensin-converting enzyme inhibition (ACE-I) activity exceeding 50% were chosen for 16S rDNA sequencing and safety assessment. It is noteworthy that Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 exhibited significant ACE-I activity, which was the result of strain fermentation in reconstituted skim milk. These 2 strains did not exhibit hemolytic activity or antibiotic resistance. They also did not produce biogenic amines and showed high survival rates in the gastrointestinal tract. Additionally, Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 fermented milk exhibited a notable reduction in blood pressure levels in spontaneously hypertensive rats (SHR) compared with negative controls in SHR. Importantly, no adverse effect was observed in normal Wistar-Kyoto rats. Through the analysis of physiological, serum, and urine-related indicators, it was observed that Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 have the potential to promote weight gain in SHR, alleviate excessive heart rate, improve renal function indicators, and effectively regulate blood sugar and uric acid levels in SHR. These 2 strains showed optimal properties in lowering blood pressure and have the potential to be used in functional dairy products in the future.

Comparison of the effect of hemodialysis and peritoneal dialysis in the treatment of end-stage renal disease.

To compare the clinical effects of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of end-stage renal disease (ESRD) patients. Clinical data of ESRD patients who received HD (n=74) and PD (n=77) for more than 12 months in the First People's Hospital of Tonglu County from October 2020 to November 2021 were retrospectively selected. Renal function indexes, blood pressure, and complication rates in the two groups before the first dialysis and at the end of the observation period were compared. After the dialysis, the urea nitrogen (BUN) levels decreased in both groups, and were significantly lower in the PD group compared to the HD group. Urea clearance index (Kt/V) increased, and were significantly higher in the PD group compared to the HD group (P<0.05). After the dialysis, albumin (ALB) and cardiac ejection fraction (EF) levels significantly increased, and ALB levels were significantly higher in the HD group while EF levels were significantly higher in the PD group (P<0.05). Levels of whole parathyroid hormone (iPTH), systolic blood pressure, and diastolic blood pressure indicators in both groups decreased compared to before the dialysis, and were significantly lower in the PD group compared to the HD group of patients (P<0.05). PD was associated with significantly lower total incidence of complications compared to HD (P<0.05). Peritoneal dialysis is more effective in maintaining the hemodynamic stability for ESRD patients, reducing blood pressure level, improving the clearance rate of molecular substances, and protecting the renal function of patients compared to hemodialysis.

ARTERIAL HYPERTENSION AMONG MEDICAL WORKERS. ANALYSIS. EVALUATION

The aim. To examine the impact of individual medical and social factors, including work experience, lifestyle and living conditions, excess body weight, metabolic syndrome, types of circadian rhythms of blood pressure, and heredity, on the frequency of arterial hypertension (hypertensive disease - HD) formation.&#x0D; Materials and methods. The study involved the collection of anamnestic data, conducting interviews, performing objective examinations, and monitoring blood pressure in 391 medical workers, predominantly from therapeutic, surgical, and intensive care backgrounds. The obtained data were statistically processed using probability assessment criteria, risks assessed through odds ratio (OR), and ROC analysis.&#x0D; The results. The study revealed that only 33% of medical workers have a normal body weight. The risk of developing hypertensive disease (HD) is 3.24 times higher in the group with excess body weight and 8.72 times higher in the group with obesity compared to the examined subjects with normal body weight (p&lt;0.0001). Daily blood pressure monitoring results showed a statistically significant difference in 12 out of the 21 studied parameters (p&lt;0.05) between patients with HD, with and without metabolic syndrome. This indicates that the presence of metabolic syndrome affects the severity of hypertensive disease. Additionally, a statistically significant difference (p&lt;0.05) was observed in the distribution of circadian rhythm types of blood pressure between groups with and without hypertension. It was established that there is a predominance of unfavorable types of circadian blood pressure rhythm in medical worker groups experiencing high professional psycho-emotional stress (78.1-85.5%). Recognizing the risk factors for HD occurrence in medical workers can significantly enhance the effectiveness of a comprehensive hypertensive disease prevention program, leading to reduced blood pressure levels and a lower frequency of complications.&#x0D; Conclusions. It has been established that excess body weight is a risk factor for the development of hypertensive disease (HD) in medical personnel. The presence of metabolic syndrome has been proven to affect the severity of the hypertensive disease course. There is a certain association between disruptions in circadian blood pressure rhythms, professional psycho-emotional stress, and the development of arterial hypertension in medical workers of certain specialties. The prognostically significant threshold level of work experience for the formation of a group at an increased risk of developing HD is 11 years.

Efficacy observation of pushing Qiaogong point with different intensities for treating stage I essential hypertension

ObjectiveTo observe the clinical efficacy of pushing Qiaogong point with varying intensities for treating stage I essential hypertension.MethodsA total of 72 patients diagnosed with stage I essential hypertension were enrolled in this study. They were divided into three groups using the random number table method, including a control group, a gentle pushing group, and a heavy pushing group, with 24 patients in each group. All three groups received the same therapeutic lifestyle interventions. The control group received no additional interventions, the gentle pushing group received additional pushing Qiaogong point with gentle strength, and the heavy pushing group received additional pushing Qiaogong point with heavy strength. The treatment duration was 4 weeks, followed by a 4-week follow-up period, during which blood pressure changes were observed and analyzed in all three groups.ResultsAfter treatment, the blood pressure levels in all three groups showed a significant decrease (P<0.05). The effective rate in the control group was 43.5%, in the gentle pushing group was 78.3%, and in the heavy pushing group was 33.3%. The reduction in blood pressure levels in the gentle pushing group was significantly superior to that in both the control group and the heavy pushing group, indicating inter-group statistical significance (P<0.01). The efficacy of the heavy pushing group was comparable to that of the control group, indicating no statistical significance (P>0.05). During the follow-up period, compared with the end of the treatment within the same group, the blood pressure levels remained stable in both the control group and the gentle pushing group, indicating no intra-group statistical significance (P>0.05). The heavy pushing group showed a significant decrease in diastolic blood pressure (DBP) and mean blood pressure (MBP) compared with the end of the treatment, indicating intra-group statistical significance (P<0.05). During the follow-up, the gentle pushing group had lower systolic blood pressure (SBP) and MBP compared with both the heavy pushing group and the control group, indicating inter-group statistical significance (P<0.01), while there was no inter-group statistical significance in comparing the DBP (P>0.05). There was no statistical significance in comparing the SBP, DBP, and MBP between the heavy pushing group and the control group (P>0.05).ConclusionPushing Qiaogong point with gentle strength combined with lifestyle interventions showed a higher effective rate and long-term blood pressure stability in the treatment of stage I essential hypertension. Pushing Qiaogong point with varying intensities showed varying effects on patients with stage I essential hypertension.

The Efficacy of Deep Breathing Techniques in Patients with Elevated Blood Pressure and Hypertension: A Review of the Literature

Introduction: Increased blood pressure (BP) is among the top modifiable causes of cardiovascular disease risk. Non- pharmacological interventions in the prevention and management of elevated BP and hypertension have increased in popularity in recent years. Deep breathing techniques (DBT) are mindfulness stress reduction strategies that target the autonomous nervous system, increase vagal tone, and reduce BP levels. Inconsistent evidence exists in the efficacy of DB techniques in BP control. This review of the literature aims to assess the overall BP lowering efficacy of DBT in hypertension, compare the efficacy of device-guided versus non-device-guided DBT, and assess the safety and adherence rate of DBT, through systematic search and review of randomized controlled trials. Methods: We searched Randomized clinical trials (RCT) in PubMed and Cochrane databases. The search terms were divided into three-term groups: a) hypertension, b) deep breathing techniques, and c) trials. Then, the list of articles was divided into five groups, each with two to three reviewers, to verify every study met the inclusion and exclusion criteria by reading the title and the abstract. Whenever necessary, we downloaded articles to verify adherence by reading the methods, results, and discussions. Studies having two or more votes were selected. Next, all selected articles were downloaded and read to analyze findings and effect sizes and to confirm a correct methodology and statistical analysis. Results: We selected 4 of 119 articles. There is a conflict in the literature; one study affirms no overall difference between DBT and control, two studies affirm that there are statistically significant differences, and one study reports no difference in office BP but statistical difference in “awake, at home” monitoring in the control group. Thus large-scale, high-quality clinical trials are needed to critically assess the effectiveness of long-term DBT in the management of HTN.

Efficacy of continuous positive airway pressure (CPAP) therapy in patients with sleep apnea and resistant hypertension

CPAP treatment reduction blood pressure levels, degree of reduction in blood pressure levels is similar to those achieved by some antihypertensive drugs, especially in patients with resistant hypertension. There is a positive and linear correlation between the hours of use of CPAP and the reduction in blood pressure levels. CPAP decreases both the sympathetic activity and the level of aldosterone concentration on resistant hypertension patients, and these could constitute some of the pathophysiological action mechanisms involved in this treatment. The treatment and adherence to CPAP therapy along with other antihypertensive medications greatly reduce and prevent high blood pressure, CVD, and stroke.

DIETARY SODIUM RESTRICTION REDUCES NOCTURNAL BLOOD PRESSURE IN PATIENTS WITH TREATMENT RESISTANT HYPERTENSION

Objective: Patients with treatment resistant hypertension (TRH) are characterised by lack of blood pressure (BP) control despite antihypertensive treatment. They are at particular risk of cardiovascular disease and more likely to experience BP increase as a response to sodium loading than other individuals. In this study, we aimed to analyse if self-performed dietary sodium restriction could be implemented in patients with TRH. Moreover, we aimed to analyse the effect of this on nocturnal and 24h BP, and how BP changes were correlated to changes in plasma levels of BNP, nitric oxide and body water content. Design and method: The study was conducted as an interventional cross-over study including patients with TRH from 20-70 years. Patients were screened with 24h ambulatory BP monitoring initiated after observed intake of usual antihypertensive medication. They were included if 24h systolic BP&gt;130/80 mmHg. Study participation included two periods of 14 days; a standard period with usual diet and an interventional period with instructed dietary sodium restriction and handed-out sodium-free bread. At the end of each period, patients were examined with 24h BP monitoring, 24h urine collection (sodium excretion), blood samples (nitric oxide, BNP), and bioimpedance measurement (body water content). Results: Participation was completed by 15 patients with mean age 59 years and mean 24h BP 144/82 mmHg. Mean baseline urinary sodium excretion was 192(86) mmol/24h (11.2 grams of salt). As seen in Table 1, sodium excretion was reduced to 91 mmol/24h equalling 5.3 grams of salt. BP levels were reduced significantly. Plasma levels of nitric oxide increased significantly, and this was correlated to the change in 24h BP. Total body water content and plasma levels of BNP was reduced significantly. The changes in BP were not correlated to changes in sodium excretion, body water or BNP. Conclusions: Self-performed dietary sodium restriction could be implemented resulting in a significant reduction in BP levels. BP change was not related to changes in body water or sodium excretion. Increased levels of nitric oxide may be evidence of improved endothelial function and may be one of the involved mechanisms in BP decrease following sodium restriction