Rise In Systolic Blood Pressure Research Articles

Sleep Duration Irregularity is Associated with Elevated Blood Pressure During Submaximal Exercise in Young Adults.

Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP measured during exercise after controlling for factors known to influence the exercise pressor reflex. Twenty-nine young adults (22±4y; 19 men, 10 women) performed cycling exercise until volitional fatigue to assess peak oxygen uptake (VO2). Actigraphy was used to monitor sleep duration and daily physical activity for seven consecutive days after which participants completed two bouts of moderate-intensity cycling while BP and VO2 were measured using a Tango+ device and indirect calorimetry, respectively. Systolic BP was averaged from the two bouts of exercise and expressed as a change from seated rest (∆SBP). Sleep duration regularity was calculated as standard deviation (SD) and coefficient of variation (CV). Systolic BP at seated rest, during exercise, and ∆SBP was 113±13, 152±21, and 38±13 mmHg, respectively. Sleep duration SD (range 10-146 min) and sleep duration CV (range 2-54%) when excluding weekend nights were significantly correlated with ∆SBP (r = 0.58 and r = 0.62, respectively; both p<0.01) after adjusting for age, sex, body mass index, peak VO2, physical activity, resting systolic BP, chronotype, and the VO2 response to exercise. Sleep duration regularity analyzed with weekend nights included (across all seven days) was also significantly correlated with ∆SBP (p≤0.01), but had weaker correlation coefficients. These results indicate that sleep regularity, especially when excluding weekend nights, is associated with the rise in systolic BP during moderate-intensity exercise in young adults. Sleep duration regularity may be a useful tool to capture the impact of intermittent nights of insufficient sleep on BP dysregulation.

Assessment of arterial rigidity and daily profile of arterial pressure in women with newly detected breast cancer

Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM. Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV &gt;10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP &gt;125 mm Hg and pulse BP &gt;60 mm Hg was highest in patients with EH.Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.

Comparison of Nocturnal Blood Pressure Patterns between Parkinson’s Disease, Cerebrovascular, and Other Neurological Diseases

Background: The rise in average systolic blood pressure at night compared with daytime is called reverse dipping. Reverse dipping is one of the indicators of autonomic dysfunction in Parkinson’s disease (PD). Reverse dipping may increase cardiovascular mortality. We aimed to document nocturnal blood pressure patterns of patients with Parkinson’s Disease, cerebrovascular diseases, and other neurological diseases. Method: Patients who applied to the neurology department between 2012 and 2016 and had 24-h ambulatory blood pressure monitoring were enrolled. Patients without an MRI examination were excluded. Patients in the cerebrovascular disease group had ischemic stroke, transient ischemic attack, vascular parkinsonism, and/or vascular dementia. The patients who did not have PD or cerebrovascular disease were assigned to the other neurological diseases group. Nocturnal blood pressure patterns were examined and categorized into two as dipping/non-dipping and reverse dipping. Dipping/non-dipping and reverse dipping rates were compared between groups. The difference between the groups was evaluated using the chi-square test. Results: A total of 126 patients were enrolled, 59% (n:74) of them were female while 41% (n:52) were male. The median age was 62 (18 - 88) years. The rates of dipping, non-dipping, and reverse dipping were as follows; 5.3%, 57.9%, 36.8% in the PD, 37%, 40.7%, 22.2% in the cerebrovascular disease, and 37.5%, 51.2%, and 11.3% in the other neurological diseases group. The rate of reverse dipping was significantly higher in the PD group (p=0.024), while it was lower in other neurological disease group (p=0.029). The rates in the cerebrovascular disease group were not statistically different. Conclusion: Reverse dipping is an important yet unnoticed autonomic dysfunction feature which can increase cardiovascular mortality in PD patients.

Tubular deficiency of ABCA1 augments cholesterol- and Na+-dependent effects on systemic blood pressure in male mice.

Dyslipidemia, with changes in plasma membrane (PM) composition, is associated with hypertension, while rising PM cholesterol induces Na+ channel activity. We hypothesize that ablation of renal tubular ABCA1, a cholesterol efflux protein, leads to cholesterol- and Na+-dependent changes in blood pressure (BP). Transgenic mice (TgPAX8rtTA;tetO-Cre/+) expressing a doxycycline (dox)-inducible CRE recombinase were bred with mice expressing floxed ABCA1 to generate renal tubules deficient in ABCA1 (ABCA1FF). Tail-cuff systolic BP (SBP) was measured in mice on specific diets. Immunoblotting was performed on whole and PM protein lysates of kidney from mice completing experimental diets. Cortical PM of ABCA1FF showed reduced ABCA1 (60 ± 28%; n = 10, P < 0.05) compared with wild-type littermates (WT; n = 9). Tail-cuff SBP of ABCA1FF (n = 11) was not only greater post dox, but also during cholesterol or high Na+ feeding (P < 0.05) compared with WT mice (n = 15). A Na+-deficient diet abolished the difference, while 6 wk of cholesterol diet raised SBP in ABCA1FF compared with mice before cholesterol feeding (P < 0.05). No difference in α-ENaC protein abundance was noted in kidney lysate; however, γ-ENaC increased in ABCA1FF mice versus WT mice. In kidney membranes, NKCC2 abundance was greater in ABCA1FF versus WT mice. Cortical lysates of ABCA1FF mouse kidneys expressed less renin and angiotensin I receptor than WT mouse kidneys. Furosemide injection induced a greater diuretic effect in ABCA1FF (n = 7; 45.2 ± 8.7 µL/g body wt) versus WT (n = 7; 33.1 ± 6.9 µL/g body wt; P < 0.05) but amiloride did not. Tubular ABCA1 deficiency induces cholesterol-dependent rise in SBP and modest Na+ sensitivity of SBP, which we speculate is partly related to Na+ transporters and channels.NEW & NOTEWORTHY Cholesterol has been linked to greater Na+ channel activity in kidney cells, which may predispose to systemic hypertension. We showed that when ABCA1, a protein that removes cholesterol from tissues, is ablated from mouse kidneys, systemic blood pressure is greater than normal mice. Dietary cholesterol further increases blood pressure in transgenic mice, whereas low dietary salt intake reduced blood pressure to that of normal mice. Thus, we speculate that diseases and pharmaceuticals that reduce renal ABCA1 expression, like diabetes and calcineurin inhibitors, respectively, contribute to the prominence of hypertension in their clinical presentation.

Peculiarities of ambulatory blood pressure monitoring in patients who have suffered from COVID-19

Violations of blood pressure control in patients who have had COVID-19 can be due to many pathophysiological factors. Further study of the features of blood pressure (BP) fluctuations in this category of patients will allow to diagnose arterial hypertension (AH) on time, to identify the uncontrolled course of AH and to select the optimal tactics of patients’ management. It was suggested to determine the characteristics of BP fluctuations in patients who have suffered from COVID-19 more than 12 weeks ago, based on the results of ambulatory (daily) blood pressure monitoring. 98 patients (51 men – 52.0%, 47 women – 47.9%) who have had COVID-19 infection more than 12 weeks ago were examined. Patients were divided into 2 groups – with and without a history of AH. The groups of examinees were homogeneous in age and gender. Ambulatory blood pressure monitoring (AM BP) was carried out on the CardioTens apparatus (Meditech, Hungary) according to the standard method. According to the data of AM BP in patients with AH in the anamnesis, who have suffered from COVID-19 more than 12 weeks ago, significantly higher average indicators of daily systolic blood pressure were recorded, and significant violations of the indicators of variability of systolic blood pressure during the day and night periods, pressure load during the day period, as well as a significantly higher degree and the rate of the morning rise in systolic blood pressure. In patients without a history of AH who have suffered from COVID-19 more than 12 weeks ago, in 21.4% cases there was newly diagnosed AH, in 33.3% of cases, increased variability of systolic blood pressure was observed, mainly during the day, in 21.4% of cases, the degree and speed of the morning rise of systolic blood pressure were increased, which indicated the presence of hypertensive reactions to household loads. In patients with a history of AH, in 55.3% of cases there was observed an increase in average blood pressure values per day, during the day and night periods, which was considered as ineffective blood pressure control and required an increase in the doses of previously prescribed antihypertensive drugs or the use of additional antihypertensive drugs in the treatment regimen. In patients with AH in the anamnesis, who have suffered from COVID-19 more than 12 weeks ago, reliable violations of many indicators of AM BP, deterioration of blood pressure control were recorded. In the patients, who did not have AH and who have suffered from COVID-19 more than 12 weeks ago, the presence of a hypertensive reaction to household loads and newly diagnosed AH were odserved.

A COMPARATIVE STUDY TO ASSESS EFFECTS OF PNEUMOPERITONEUM AND TRENDELENBURG POSITION ON HEMODYNAMICS AND VENTILATORY MECHANICS DURING TOTAL LAPAROSCOPIC HYSTERECTOMY IN OBESE AND NON-OBESE PATIENTS

Background:Hysterectomy is a common gynaecological surgical procedure, with Laparoscopic hysterectomy (LH) emerging as a favorable approach due to its benefits such as shorter recovery periods and reduced complications. However, the creation of pneumoperitoneum and the Trendelenburg position required for total laparoscopic hysterectomy (TLH) can induce significant hemodynamic and ventilatory changes. Methodology: Our study included 60 patients who were categorized into two groups of 30 each based on their BMI: non-obese (BMI &lt; 30) and obese (BMI ≥ 30). All patients underwent routine pre-anaesthesia check-up followed by general anaesthesia. Diastolic blood pressure (DBP), systolic blood pressure (SBP), peripheral oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP), plateau pressure (PPLAT), peak pressure (PPEAK),and driving pressure (PDRIVING), end-tidal carbon dioxide (EtCO2) as well as static (CST) and dynamic (CDYN) lung compliance were measured at different time intervals including baseline, following induction of anaesthesia, insufflation, changing to Trendelenburg position, desufflation and after extubation. Results:The heart rate decreased on induction of anesthesia in both the groups and remained lower throughout the procedure but was statistically non-significant (p&gt;0.05). There was a rise in SBP, DBP, and MAP on insufflation and further with head-down positioning in both obese and non-obese patients, however, was statistically non-significant (p&gt;0.05). The PPEAK, PPLAT, and PDRIVING were increased on induction, following the creation of pneumoperitoneum as well as Trendelenburg position (p&lt;0.05). The values were higher in obese as compared to the non-obese. The static and dynamic compliance were lower at all time intervals in obese patients when compared to the non-obese group. Conclusion: Obese patients exhibit higher plateau pressure, peak inspiratory pressure, and driving pressure values, indicating increased airway resistance and potential ventilation challenges during surgery. Additionally, the reduced static and dynamic lung compliance values in obese patients suggest decreased lung elasticity and difficult ventilation.

Frequency and risk factors stratification of hypertension among the rural population of Bangladesh

Background and Objectives: Hypertension is one of the major risk factors of premature morbidity and mortality in our daily clinical practice. Various studies carried out in the urban settings, but there is scarcity of epidemiological data regarding hypertension among the rural people in Bangladesh. Therefore, this current study has been designed to find out the frequency and risk factors stratification of hypertension among the rural people in Jashore, Bangladesh. Materials and Methods: A cross-sectional study recruited 1812 participants above 18 years attending on national hypertensive week of 2019 in Bagherpara and Keshabpur upazila (subdistrict) health complex in Jashore, Bangladesh. 2020 International Society of Hypertension Global Hypertension Practice Guidelines had been demonstrated to classify hypertension. Results: Out of the total study population, the frequency of hypertension was 20.6% (Grade 1 and Grade 2 hypertensive patients 15.8% and 4.9%, respectively), and high normal blood pressure was 9.0%. The mean age of the study population, Grade 1 hypertensive and Grade 2 hypertensive cohorts were 42 ± 16, 49 ± 15 and 51 ± 14 years, respectively, with a male and female ratio was 1:2. Progressive rise of mean systolic and diastolic blood pressure were noticed with increasing age. Age (P: &lt;0.001), sex (P: 0.004), occupation (P: &lt;0.001), BMI (P: &lt;0.001), family (P: &lt;0.001) and past history (P: &lt;0.001) of hypertension, sedentary life style (P: 0.004), additional salt intake (P: &lt;0.001) and smoking (P: 0.011) were significantly associated with hypertension following bivariate analysis. Multivariate logistic regression analysis revealed that age after 50 years (AOR = 1.866, 95% CI: 1.210-2.876), positive past history of hypertension (AOR = 3.493, 95% CI: 2.676-4.558), additional salt intake (AOR = 0.591, 95% CI: 0.453-0.770) and obesity (AOR = 3.389, 95% CI: 1.830-6.274) were significantly associated with developing hypertension. Conclusion: High frequency of hypertension was found among the rural population in Bangladesh where presence with a lot of significantly associated risk factors. The data would be helpful for the health policymakers dealing noncommunicable diseases to reach the sustainable goal and mitigate morbidity and mortality of cardiovascular diseases in Bangladesh.

Invisible pollution and hypertension: Evidence from the aging population in China

Hypertension, a prevalent health concern within China's aging population, is the focal point of this study. The aim is to draw causal conclusions on the impact of ozone pollution on hypertension incidence and blood pressure elevation, using an instrumental variable derived from the wind-borne long-distance transmission of ozone. The findings suggest a causal effect of ozone on blood pressure and hypertension incidence; a one-part-per-billion increase in the ambient ozone level during the preceding four months causes a rise in systolic and diastolic blood pressure (0.5281 mmHg and 0.3796 mmHg, respectively), and a 0.52 percentage point surge in hypertension incidence. These effects are potentially due to physiological and behavioral factors, including elevated inflammation and oxidative stress, increased obesity rates, and reduced sleep duration. Importantly, this study emphasizes the substantial health benefits achievable through ozone pollution control. A one-standard-deviation decrease in ozone concentration could potentially result in an estimated reduction of 28.13 million hypertensive older adult patients by mid-century, consequently lowering medical expenditure by approximately 3.83 billion USD.

Hemodynamic Determinants of Elevated Blood Pressure and Hypertension in the Middle to Older-Age UK Population: A UK Biobank Imaging Study.

Increased systemic vascular resistance and, in older people, reduced aortic distensibility, are thought to be the hemodynamic determinants of primary hypertension but cardiac output could also be important. We examined the hemodynamics of elevated blood pressure and hypertension in the middle to older-aged UK population participating in the UK Biobank imaging studies. Cardiac output, systemic vascular resistance, and aortic distensibility were measured from cardiac magnetic resonance imaging in 31 112 (distensibility in 21 178) participants (46.3% male, mean age±SD 63±7 years). Body composition including visceral adipose tissue volume and abdominal subcutaneous adipose tissue volume were measured in 19 645 participants. Participants with higher blood pressure had higher cardiac output (higher by 17.9±26.6% in hypertensive compared with those with optimal blood pressure) and higher systemic vascular resistance (higher by 11.4±27.9% in hypertensive compared with those with optimal blood pressure). These differences were little changed after adjustment for body size and adiposity. The contribution of cardiac output relative to systemic vascular resistance was more marked in younger compared with older subjects. Aortic distensibility decreased with age and was lower in participants with higher compared with lower blood pressure but with a greater difference in younger compared with older subjects. In the middle to older-aged UK population, cardiac output plays an important role in contributing to elevated mean arterial blood pressure, particularly in younger compared with older subjects. Reduced aortic distensibility contributes to a rise in pulse pressure and systolic blood pressure at all ages.

Abstract P220: Angiotensin II Dependent And Independent Pressor Effect Of Ang-(1-12)

Background: Ang-(1-12) serves as a functional substrate for the formation of Ang II in the blood and tissues. It remains unknown whether the hypertensive effect of Ang-(1-12) is solely caused by Ang II formation or whether the peptide itself exerts a pressor effect by binding to the AT1-receptor or a yet-to-be-identified receptor subtype. Here we examined the possibility of Ang II independent pressor effects of Ang-(1-12). Methods: Anesthetized male c57bl6 mice were injected with Ang II or Ang-(1-12) (0.2 μg/g BW) and the systolic blood pressure (SBP) was measured continuously for 15 minutes. To evaluate whether Ang-(1–12) vasoconstrictor activity is due to its processing into Ang II, mice were preinjected with Telmisartan or Lisinopril before Ang-(1-12) injection. We further assessed the effect of recombinant (r) ACE2 as a way to augment Ang II metabolism and therefore unravel Ang II independent pressor effects of Ang-(1-12). Results: Ang-(1-12) infusion led to a peak increase in SBP almost as high as Ang II (145 ±24 mmHg vs. 160±26 mmHg, respectively). The pressor effect of Ang-(1-12) was completely abolished by either Telmisartan or Lisinopril (103±11 mmHg and 98±12 mmHg, respectively). rACE2 prevented the sustained rise in SBP induced by Ang II (Fig. 1), but it did not affect the pressor effect of Ang-(1-12) (Fig. 1). Conclusions: Ang-(1–12) hypertensive effect is blocked by RAS blockade consistent with an action dependent on Ang II formation and coupling to AT-1 receptors. In contrast, Ang-(1–12) pressor activity is not modified when Ang II is rapidly metabolized by rACE2. These data suggest a vasoactive action of Ang-(1–12) that is, in part, independent of its conversion into Ang II.

Abstract 005: Renal Macrophages From Losartan Treated Mice Transfer The Hypertension

The immune system participates in the Angiotensin II (AngII)-dependent hypertension (HTN). Dendritic Cells (DCs)-CD11c + and macrophages (Mo) are abundant in the kidney. However, new subpopulations of CD11c + cells with Mo characteristics (F4/80 + ) have been described. Recently, studies have shown that type-1 AngII receptor (AT 1 R) in CD11c + cells could have a protective effect on HTN in contrast to the pro-hypertensive effects of AT 1 R activation in other cells. Here, our goal was to evaluate whether renal Mo (rMo) modify their phenotype during AngII-induced inflammatory kidney damage, and whether their transfer to normotensive animals promotes HTN in an AT 1 R-dependent manner. Male C57BI/6 mice (10 weeks, n=6) were infused with AngII (490 ng/kg/min), AngII+Losartan (LOS; 20mg/kg/d, in drinking water), or vehicle (Vh) for 14-days. Systolic blood pressure (SBP) was measured by plethysmography. Renal DCs (rDCs, CD11c + F4/80 - ) and rMo (CD11c + F4/80 + ) were evaluated by flow cytometry and isolated at 14-days for the transfer to normotensive mice, which were followed for 7-days (n=4-5). Finally, rDCs and rMo were stimulated in vitro with AngII (100nM, 24h) to analyze the mRNAs abundance of AT 1 R. All data are presented by mean±standard deviation.LOS prevented the SBP rise (AngII+LOS=110.3±11.1 vs. AngII=134.7±6.9 mmHg; p&lt;0.01) and the increase of rDCs population (AngII+LOS=12.8±2.0% vs. AngII=16.5±0.6%; p&lt;0.01) induced by AngII, without changing rMo population. The rMo transfer from AngII mice did not induce HTN in normotensive animals after 24h (basal=106.8±2.3 vs. 112.4±4.9 mmHg; ns), compared to rDCs (Basal=110.0±8.3 vs. 132.0±14.3 mmHg; p&lt;0.05). However, the rMo from AngII+LOS mice increased SBP in healthy animals compared to their baseline (basal=109±5.6 vs. 123±8.0 mmHg; p&lt;0.05). This effect was not observed by rDCs transfer (basal=109±2.9 vs. 113±7.0 mmHg; ns). Finally, the rMo from AngII mice showed an increase in the AT 1 R mRNA abundance (p&lt;0.05), compared to Vh rMo, however, AngII in vitro treatment did not modify the mRNA levels.The in vivo AT 1 R antagonism may have a differential effect on rMo, transferring HTN to normotensive mice. These findings suggest that subpopulations of renal CD11c + cells have a differential role in HTN.Fondecyt 1231909

Time and frequency domain analysis of physiological features during autonomic dysreflexia after spinal cord injury.

Autonomic dysreflexia (AD) affects about 70% of individuals with spinal cord injury (SCI) and can have severe consequences, including death if not promptly detected and managed. The current gold standard for AD detection involves continuous blood pressure monitoring, which can be inconvenient. Therefore, a non-invasive detection device would be valuable for rapid and continuous AD detection. Implanted rodent models were used to analyze autonomic dysreflexia after spinal cord injury. Skin nerve activity (SKNA) features were extracted from ECG signals recorded non-invasively, using ECG electrodes. At the same time, blood pressure and ECG data sampled was collected using an implanted telemetry device. Heart rate variability (HRV) features were extracted from these ECG signals. SKNA and HRV parameters were analyzed in both the time and frequency domain. We found that SKNA features showed an increase approximately 18 seconds before the typical rise in systolic blood pressure, indicating the onset of AD in a rat model with upper thoracic SCI. Additionally, low-frequency components of SKNA in the frequency domain were dominant during AD, suggesting their potential inclusion in an AD detection system for improved accuracy. Utilizing SKNA measurements could enable early alerts to individuals with SCI, allowing timely intervention and mitigation of the adverse effects of AD, thereby enhancing their overall well-being and safety.

ASSOCIATION OF ANGIOTENSIN-CONVERTING ENZYME I/D POLYMORPHISM AND HYPERTENSION AMONG YOUNG ADULTS: A PILOT STUDY FROM DELHI

Objective: Angiotensin converting enzyme (ACE) gene is a potent vasoconstrictor and directly involved in cell proliferation, differentiation, apoptosis and angiogenesis. Studies have reported that ACE gene activates the conversion of angiotensin I to angiotensin II and also inactive bradykinin. Bradykinin is a vasodilator which bring about its proteolysis which binds to the plasma membrane receptor and helps to produce the arteriolar constriction resulting in the rise of systolic and diastolic blood pressure. Blood pressure is additionally influenced by the interaction of genetic and other environmental factors, therefore this study tries to find an association between angiotensin-converting enzyme I/D polymorphism and hypertension among young adults Design and method: The present study was a cross sectional study conducted among young adults either sex from the age group of 18-30 living in Delhi, India. Standardized questionnaire was administered to collect data on demographic and physiological measurement. Overnight fasting intravenous blood of 5ml was collected on non-EDTA coated tube which were subjected to DNA extraction by salting out process (Miller, 1988). The extracted DNA was then aliquoted and amplified by allele-specific PCR followed by genotyping on 2% agarose gel (Rigat et al. 1990). The DNA was then screened for ACE I/D gene polymorphism. Statistical analysis was done using SPSS 2022 version. Results: The overall prevalence of hypertension in the given population was 25.3%. There was no significant difference in the distribution of ACE I/D genotypes wherein 17.4% of hypertensives were of the II genotype, 47% of ID genotype and 34.8% of the DD genotype. Conclusions: Although there was no significant association of ACE genotype with hypertension, which may be due to the small sample size but the significance of this study hints towards the importance of early detection and modifying lifestyle to improve overall health.of the individual as well as on the community level.

DETERMINAN KEJADIAN HIPERTENSI DI PUSKESMAS KECAMATAN TAMANSARI KOTA JAKARTA BARAT

Hypertension or high blood pressure is a rise in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg. Based on the data in Tamansari Community Health Center, West Jakarta City, Hypertension becomes the first of the tenth diseases found there. This study aims to know the factors related to Hypertension in Tamansari Community Health Center, West Jakarta City. The study design of this study is a case-control study design. Fifty samples were taken in each group case-control with the Non-Probability Sampling technique, Accidental Sampling. The data is analyzed using the Chi-Square test. The result of the univariate analysis shows respondent proportion &gt;40 years old (58%), gender (49%), family history (67%), obesity (61%), lack of physical activity (50%), smoking habit (37%), and excessive consumption of atrium (41%). The bivariate test result shows related variables to Hypertension are age, gender, family history, physical activity, and atrium consumption. While unrelated variables are obesity, smoking habit, and alcohol consumption. Tamansari Community Health Center, West Jakarta City, should improve its promotive program, such as health counseling about hypertension risk factors, to the public to prevent and reduce Hypertension.

Frequency and Risk Factors Stratifi-cation of Hypertension among the Rural Population of Bangladesh

Background: One of major predictors of premature mortality and morbidity; and scarcity of epidemiological data regarding hypertension among the rural people in Bangladesh, the study has been designed to find out the frequency and risk factors stratification of hypertension among the rural people in Jashore, Bangladesh. Methods: A cross-sectional study recruited 1812 participants above 18 years attending on national hypertensive week of 2019 in Bagherpara and Keshabpur upazila (sub-district) health complex in Jashore, Bangladesh. 2020 International Society of Hypertension Global Hypertension Practice Guidelines had been demonstrated to classify hypertension. Results: Out of the total study population, the frequency of hypertension was 20.6% (Grade 1 and Grade 2 hypertensive patients 15.8% and 4.9% respectively), and high normal blood pressure was 9.0%. The mean age of the study population, Grade 1 hypertensive and Grade 2 hypertensive cohorts were 42 ±16, 49±15 and 51±14 years respectively with a male and female ratio was 1:2. Progressive rise of mean systolic and diastolic blood pressure occurred with increasing age. Age(p:&lt;0.001), sex(p:0.004), occupation (p:&lt;0.001), BMI(p:&lt;0.001), family(p:&lt;0.001) and past history (p:&lt;0.001) of hypertension, sedentary life style(p:0.004), additional salt intake(p:&lt;0.001) and smoking(p:0.011) were significantly associated with hypertension following bivariate analysis. Multivariate logistic regression analysis revealed that age after 50 years (AOR=1.866, 95% CI: 1.210-2.876), positive past history of hypertension (AOR=3.493, 95% CI: 2.676- 4.558), additional salt intake (AOR=0.591, 95% CI: 0.453-0.770) and obesity (AOR=3.389, 95% CI: 1.830-6.274) were significantly associated with developing hypertension. Conclusion: High frequency of hypertension was found among the rural population in Bangladesh where a lot of significantly associated risk factors. The data would be helpful for the health policy makers dealing Non-communicable diseases to reach the sustainable goal and mitigate morbidity and mortality of cardiovascular diseases in Bangladesh. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 205

Oscillometric arterial blood pressure in haemodynamically stable neonates in the first 2 weeks of life

BackgroundWe aimed to provide data on the normal blood pressure of haemodynamically stable neonates. Our study uses retrospective, real-life oscillometric blood pressure measurement values to determine the expected blood pressure in different gestational age, chronological age and birth weight groups. We also investigated the effect of antenatal steroid on neonatal blood pressure.MethodsOur retrospective study (2019–2021) was carried out in the Neonatal Intensive Care Unit of the University of Szeged, Hungary. We involved 629 haemodynamically stable patients and analysed 134,938 blood pressure values. Data were collected from electronic hospital records of IntelliSpace Critical Care Anesthesia by Phillips. We used the PDAnalyser program for data handling and the IBM SPSS program for statistical analysis.ResultsWe found a significant difference between the blood pressure of each gestational age group in the first 14 days of life. The systolic, diastolic and mean blood pressure rise are steeper in the preterm group than in the term group in the first 3 days of life. No significant blood pressure differences were found between the group with a complete antenatal steroid course and those who received incomplete steroid prophylaxis or did not receive antenatal steroids.ConclusionWe determined the average blood pressure of stable neonates and obtained normative data by percentiles. Our study provides additional data on how blood pressure varies with gestational age and birth weight.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

The role of three-dimensional models in preoperative communication and postoperative management of partial nephrectomy

ObjectiveThis study aims to examine the significance of utilizing three-dimensional (3D) image reconstruction technique in preoperative communication prior to partial nephrectomy (PN) and its impact on postoperative follow-up. MethodsA retrospective study was performed with 158 renal cancer patients treated with PN at our center from May 1, 2017 to April 30, 2019. 81 patients (group A) had preoperative communication using the 3D reconstruction technique, while 77 patients (group B) did not. The surgeon explained the anatomical structure, tumor characteristics, and surgical approach in detail to the two groups of patients. Each patient completed a questionnaire. The loss to follow-up rate over a 3-year period was counted for both groups, and non-cancer-related serious complications such as renal failure and cardio-cerebrovascular disease were observed. This research did not include patients who returned for follow-up care owing to associated complications such as postoperative chronic kidney disease. Comparisons between two groups were performed using the Mann–Whitney U test and chi-square test. ResultsAll patients showed no statistically significant differences in basic clinical parameters, such as age, gender, body mass index, tumor size, and R.E.N.A.L. score (P ​> ​0.05). In group A, patients were significantly more likely to experience understanding of renal anatomy (P ​= ​0.001), characteristics of renal cell carcinoma (P ​= ​0.003), surgical approach (P ​= ​0.007), and relief of preoperative anxiety (P ​= ​0.013). The follow-up adherence at 3 years postoperatively in group A and group B was 21 cases and 10 cases, respectively (P ​= ​0.041). In addition, glomerular filtration rate < 60 ​mL/min/1.73 ​m2 or serum creatinine > 186 ​μmol/L at 3 years after surgery occurred in 5 patients in group A and 13 in group B (P ​= ​0.034), and a systolic blood pressure rise greater than 20 ​mmHg occurred in 9 patients in group A and 18 in group B (P ​= ​0.041). ConclusionsThe findings of this study suggest that the integration of 3D reconstruction techniques in preoperative communication effectively enhances patients’ understanding and perception of kidney tumors and PN. Moreover, the utilization of these techniques can contribute to the prevention of significant non-cancer-related complications during the postoperative phase.

EFFECT OF GENDER ON BLOOD PRESSURE AND HEART RATE VARIABILITY DURING INCREASING INTENSITIES OF ISOMETRIC HAND GRIP EXERCISE IN UNTRAINED ADULTS

ender influences blood pressure (BP) and heart rate variability (HRV). The purpose of this study was to investigate the influence of gender on BP and HRV during increasing intensities of isometric hand grip (IHG) exercise. Nineteen (n=19) (10 males, 9 females) participants aged 25.7±0.9 and 27.0±0.6 years (Mean± SEM), with height and weight of 173.4±3.1 cm, 72.8±3.7kg and 160.9±1.6 cm, 59.3±3.4 kg volunteered after ethical approval. BP, HRV and maximum voluntary contraction (MVC) was measured at rest. Thereafter, participants underwent 30% MVC for 2 minutes during which BP and HRV was taken with 10 minutes rest. Contractions were amplified to 35, 40, 45% MVC. One-Way ANOVA compared Mean±SEM values at 95% significance. The systolic blood pressure (SBP) increased significantly in females (p&lt;0.001) than males (p&lt;0.01); diastolic blood pressure (DBP) increased significantly in both gender (p&lt;0.001); average number of heart beats increased significantly in males (p&lt;0.001) than females (p&lt;0.01); significant increase in LF/HF ratio in females (p&lt;0.01) but not in males. However, there was no significant difference in the standard deviation of N-N interval (SDNN), low frequency (LF), high frequency (HF), very low frequency (VLF), root mean square of standard deviation (RMSSD), total frequency power (TFP), proportion of numbers of pairs of successive intervals (Pnn50) in both genders. This study may suggest a higher sympathetic influence (following rise in SBP and LF/HF ratio) in females than males during IHG exercise. Thus, variations exist in BP and HRV during short interval, altered intensities IHG exercise in both genders.

Study on Perioperative Management of Blood Pressure and Effects of Anaesthesia in Hypertensive Patients Undergoing General &amp; Orthopaedic Surgery

Background and Aim: During anesthesia, hypertension is the most common additional risk factor that contributes to higher mortality rate. Antihypertension medicine’s withdrawal might leads to symptoms such as anxiety, rebound hypertension, myocardial infarction, tachyarrhythmia, angina exaggeration, and sudden death. The present study aimed to assess the perioperative management of blood pressure and effects of anesthesia in hypertensive patients undergoing general and orthopedic surgery. Patients and Methods: This cross-sectional study was carried out on 162 hypertensive patients in the General Surgery and Orthopedics Units of Khyber Teaching Hospital, Peshawar for the duration from April 2022 to September 2022. Study protocol was approved by institute ethical committee. Patients aged 16 to 70 years of either gender underwent general surgery and orthopaedic surgery were enrolled. The data was acquired during the anesthetist’s initial visit to the operated hypertensive patients' 24 hour postoperative period. Antihypertensive medications, hemodynamics, anesthesia drugs, fluid use, and blood loss were main variables noted. Heart rate, systolic blood pressure, and diastolic blood pressure were Intraoperative hemodynamics. SPSS version 27 was used for data analysis. Results: Of the total 162 hypertensive patients, there were 68 (42%) male and 94 (58%) females. The overall mean age was 58.62±8.4 years. Before surgery, about 119 (73.5%) patients took antihypertensive medication whereas 124 (76.5%) had antihypertensive medication within 24 hours. The most prevalent antihypertensive medication used and most common class during postoperative management was Calcium channel Blockers and Amlodipine. The most prevalent used anesthetic drug use was Bupivacaine. The incidence of Systolic Blood Pressure (SBP) fall and rise was found in 28 and 6 patients respectively. The incidence of Diastolic Blood Pressure (DBP) fall and rise during intraoperative management was 11 and 8 patient respectively. Conclusion: The present study found that a decreased heart rate in patients who were taking beta blockers consistently. Those who took diuretics had greater DBP and HR at the completion of the procedure. There was no significant change in hemodynamic parameters with any other antihypertensive treatment. Keywords: Hypertension, General Surgery, Orthopaedic, Hemodynamics

Phenylephrine and Ephedrine for Prevention of Hypotension in Women during Lower Segment Caesarean Section under Spinal Anaesthesia: A Randomised Clinical Study

Introduction: Hypotension is the most common serious adverse event associated with Spinal Anaesthesia (SA) and is associated with nausea and vomiting leading to pulmonary aspiration, respiratory depression and cardiac arrest. Phenylephrine (PE) and Ephedrine (EP) are vasopressors commonly used for prevention of hypotension associated with SA. Aim: To compare the efficacy and safety of PE and EP in prevention of hypotension induced by SA in women during Lower Segment Caesarean Section (LSCS) surgery. Materials and Methods: The present randomised clinical study was conducted on 60 women, between 18-36 years of age and a Heart Rate (HR) of 60-100 per minute randomised to receive either 100 mcg Intravenous (i.v.) bolus of PE, or 12 mg i.v. of EP during intrathecal block. Women having intraoperative hypotension were injected additional doses of vasopressor. Cardiovascular parameters were recorded at baseline (before block) and then at 1, 5, 10, 15, 30, 40 and 60 minutes. Further, safety was also assessed based on hypotension events and adverse events reported during immediate postoperative period. Data analysis was done using IBM SPSS 17 and a p-value &lt;0.05 was considered statistically significant. Results: The mean age of the study participants in PE and EP group was 26.67±5.40 and 26.23±4.59 years, respectively. Significant differences were observed between PE and EP groups for change in Systolic Blood Pressure (SBP) after 1, 10, 30, 40 and 60 minutes. Overall, there was a slight fall in SBP with PE, whereas, with EP there was a slight rise in SBP. Also, the Diastolic Blood Pressure (DBP) was maintained with EP throughout the 60 minute period, whereas with PE there was an initial rise in DBP followed by a slight fall in DBP. The Mean Arterial Pressure (MAP) was well maintained with PE throughout, whereas with EP there was a fall in MAP after 15 minutes. However, these changes were not clinically significant. The Pulse Rate (PR) was lower with PE compared to EP group at time points of 1, 5, 15 and 20 minutes. The mean respiratory rates and blood oxygen saturation were similar with PE and EP administration (p&gt;0.05). A total of 13 (43.3%) patients in the PE group and 14 (46%) in the EP group had adverse events excluding hypotensive patients. Conclusion: According to the findings of the present study, the i.v. bolus of 100 mcg PE and 12 mg EP administered immediately after SA are equally effective in prevention of maternal hypotension and do not cause any significant cardiovascular and respiratory effects.