Systolic Blood Pressure In Women Research Articles

Exploring the association between PLGF and pregnancy outcomes

Introduction and Aim: Pregnancy demands vigilant fetal monitoring, yet traditional methods have limitations, leading to research on biomarkers like placental growth factor (PLGF) to enhance predictive accuracy for adverse outcomes. This investigation focuses on assessing the relationship between PLGF levels and pregnancy outcomes in women with suspected preeclampsia.   Materials and Methods: A simple longitudinal design was employed, following pregnant women with suspected preeclampsia from enrollment until delivery. The study included 160 subjects, and their characteristics were recorded at admission. PLGF levels were measured, and pregnancy outcomes were assessed.   Results: Among the study population, the distribution of pregnancies showed that 45.62% were in the first pregnancy, 40% in the second pregnancy, 11.85% in the third pregnancy, and 2.5% in the fifth pregnancy. The highest PLGF levels were observed in the fifth pregnancy group.Analysis revealed that subjects with NICU admission had a lower mean PLGF value compared to those without NICU admission. Among subjects with low PLGF levels, the mean baby weight was lower by approximately 5.3% when match up to those with normal PLGF levels.Regarding blood pressure, subjects with decreased PLGF levels had a higher mean systolic blood pressure in contrast   to those with normal PLGF levels.   Conclusion: Lower PLGF levels were associated with NICU admission, lower baby weight, and higher systolic blood pressure in women with suspected preeclampsia. These findings suggest that PLGF levels may have implications for pregnancy outcomes. Additional investigation with expanded sample sizes is necessary to authenticate these discoveries and look into the clinical relevance of PLGF in understanding and addressing preeclampsia.

Relationship between Serum Selenium Levels and Hypertension: Findings from the National Health and Nutrition Examination Survey, 2009–2018

Objective: This study was aimed at evaluating the association between serum selenium (Se) levels and hypertension in United States (US) adults. Methods: Data were extracted from the United States National Health and Nutrition Examination Survey (NHANES, 2009–2018). Multivariate logistic regression and subgroup analysis were conducted to examine associations between Se and hypertension. Results: Patients with hypertension had higher serum Se levels than healthy participants (P = 0.01017). After adjustment for demographic and health behaviors, serum Se levels were significantly associated with systolic blood pressure in women (OR = 0.014; 95% CI: 0.001–0.027; P = 0.04174). Serum Se levels were significantly associated with diastolic blood pressure (DBP) in both women and men. In subgroup analysis, serum Se levels were significantly associated with higher diastolic blood pressure (P for trend <0.001). Conclusion: In summary, this analysis supports a nonlinear association between serum Se levels and the prevalence of hypertension, and higher serum Se levels were associated with higher DBP.

Effect of the Red Bull Energy Drink on Perfusion-Related Variables in Women Undergoing Microsurgical Breast Reconstruction: Protocol and Analysis Plan for a Prospective, Multicenter Randomized Controlled Trial

Maintaining a sufficiently high systolic blood pressure is essential for free flap perfusion after microsurgical breast reconstruction. Yet, many women undergoing these procedures have low postoperative systolic blood pressure. Intravenous volume administration or vasopressors may be needed to maintain systolic blood pressure above a predefined threshold. However, excessive volume administration may lead to volume overload and flap stasis, and the postoperative use of vasopressors may be limited depending on institutional standards. Additional nonpharmacological measures to raise blood pressure might be beneficial. Evidence suggests that the Red Bull energy drink could raise blood pressure. It has been shown to increase systolic and diastolic blood pressure in healthy volunteers and athletes. The primary objective of this study is to determine the difference in systolic blood pressure between an intervention group receiving Red Bull and a control group receiving still water after microsurgical breast reconstruction. Secondary objectives include postoperative heart rate, 24-hour fluid balance, pain level, or necessity for revision surgery due to flap complications. The Red Bull study is a prospective, multicenter randomized controlled trial comparing the effect of postoperative ingestion of Red Bull energy drink against still water in female patients undergoing unilateral microsurgical breast reconstruction. A total of 250 mL of Red Bull (intervention group) or 250 mL of still water (control group) will be administered to the study participants 2 hours postoperatively as well as for breakfast and lunch on postoperative day 1, amounting to a total volume of 750 mL per 24 hours. Female patients between 18 and 70 years of age undergoing unilateral microsurgical breast reconstruction will be included. Exclusion criteria are a history of arterial hypertension, cardiac rhythm disorder, diabetes mellitus, gastric or duodenal ulcer, thyroid disease, and current use of antihypertensive or antiarrhythmic drugs or thyroid hormones, as well as intolerance to Red Bull. Recruitment for the study started in June 2020 and was completed in December 2022. There is evidence that the Red Bull energy drink increases blood pressure in healthy volunteers and athletes. We hypothesize that postoperative ingestion of Red Bull will increase systolic blood pressure in women after microsurgical breast reconstruction. Red Bull could hence be used as a nonpharmacological adjunct to vasopressors or volume administration in women with hypotensive blood pressure after microsurgical breast reconstruction. This paper describes the Red Bull study trial protocol and analysis plan. The information will increase the transparency of the data analysis for the Red Bull study. ClinicalTrials.gov NCT04397419; https://clinicaltrials.gov/ct2/show/NCT04397419. DERR1-10.2196/38487.

Effect Of Exercise On Cardiometabolic Health In Polycystic Ovary Syndrome: A Systematic Review And Meta-analysis

Polycystic ovary syndrome (PCOS), a common endocrine disorder in women of reproductive age, increases the risk for cardiometabolic morbidity. While regular exercise is effective in reducing cardiometabolic risk, women with PCOS may experience condition-specific barriers to exercise thereby limiting its efficacy. PURPOSE. To determine the effect of exercise on cardiometabolic risk factors in women with PCOS. METHODS. Five databases (Cochrane, EMBASE, Medline, Scopus and SPORTDiscus) were searched to July of 2020. Eligible studies included: randomised controlled design; participants with a diagnosis of PCOS; aerobic and/or resistance exercise intervention length of ≥4 weeks; cardiometabolic outcomes. Meta-analyses were performed to determine the effect of exercise versus non-exercising control on cardiometabolic outcomes. RESULTS. Of the 3,885 studies retrieved, 16 were included involving 585 participants. When compared with control, exercise significantly improved cardiorespiratory fitness (weighted mean difference [WMD] =4.12 ml/kg/min, 95%CI:2.46 to 5.79, p < 0.001), waist circumference (WMD = -1.48 cm, 95%CI:-2.35 to -0.61, p = 0.001), and systolic blood pressure (WMD = -2.80 mmHg, 95%CI:-5.09 to -0.52, p = 0.016). Fasting blood glucose, insulin resistance, and lipid profiles remained unchanged. CONCLUSIONS. Regular exercise improves various cardiometabolic risk factors including cardiorespiratory fitness, waist circumference, and systolic blood pressure in women with PCOS. Further large-scale studies are required to determine whether exercise interventions improve certain biochemical parameters in women with PCOS and more severe cardiometabolic abnormalities.

Cardiometabolic profiles in women with adenomyosis

The aim of this study was to investigate the reproductive profiles, metabolic parameters and cardiometabolic risk assessed by surrogate indexes in women with adenomyosis. Ninety-six premenopausal women who were diagnosed with adenomyosis by transvaginal ultrasound and 97 age-body mass index (BMI) matched controls with normal ultrasound during routine examination were included. Women with adenomyosis were more likely to have higher gravidity and had more abortions than women without adenomyosis. Regarding the individual metabolic syndrome components, the adenomyosis group was more likely to have higher prevalence of hypertension, low HDL-C and central obesity. No significant difference was found between the groups in terms of visceral adiposity index, lipid accumulation product and fatty liver index. Only higher blood pressure (BP) remained statistically significant after adjustment for confounding factors in multivariate analysis. Women with adenomyosis had remarkably high risk of hypertension. It may be advisable to monitor their BP closely. Impact Statement What is already known on this subject? The only anthropometric characteristic assessed in women in relation to adenomyosis is body mass index (BMI). A case-control study showed that women who are obese are more likely to have adenomyosis. The gravidity, number of spontaneous abortions and previous uterine surgeries such as dilatation and curettage (D&C) and caesarean section were found significantly associated with adenomyosis. What do the results of this study add? A remarkable finding of our study was the increased incidence of higher systolic BP in women with adenomyosis. No difference was observed in adiposity indices between women with and without adenomyosis. Higher prevalence of central obesity and lower HDL-C levels were seen in women with adenomyosis. What are the implications of these findings for clinical practice and/or further research? The study identifies that adenomyosis is associated with an increased risk of hypertension, and women with adenomyosis may be monitored closely for blood pressure changes. Our report also provides novel information about the metabolic risk profiles associated with adenomyosis.

Time trends in cardiovascular risk factors across levels of education in a general population

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Northern Norway Health Authority Background Favourable changes over time in population cardiovascular disease (CVD) risk has not benefitted all socioeconomic groups equally. Social inequality in health also exists in high-income countries with an egalitarian welfare system. Purpose We aimed to study CVD risk factors across educational groups over time in a Norwegian general population. Methods We used multivariable linear regression and generalised estimating equation models with age-adjusted means and proportions to examine CVD risk (smoking, physical activity level, obesity [body mass index ≥30 kg/m2], blood pressure, total- and low-density lipoprotein [LDL] cholesterol, and total risk of CVD [estimated 10-year risk with NORRISK 2]) across four levels of education: Primary/partly secondary up to 10 years of schooling, upper secondary, tertiary &amp;lt;4 years, tertiary ≥4 years in women and men aged 40-79 years attending a population-based study with two consecutive surveys in 2007-2008 (N=11,941) and 2015-2016 (N=20,322). Results In women, the difference between the lowest and the highest education level in risk factors in 2007-2008 versus 2015-2016 was for smoking 22.0 vs 19.2 percentage points (pp), obesity 8.7 vs 8.8 pp, sedentary physical activity level 10.5 vs 11.5 pp (p=0.012), systolic blood pressure 5.5 vs 3.4 mmHg (p=0.001), total cholesterol 0.2 mmol/L vs no difference (p&amp;lt;0.001), LDL cholesterol 0.3 vs 0.1 mmol/L (p&amp;lt;0.001), and total CVD risk 0.9 vs 1.8 (p&amp;lt;0.001), respectively. In men, the corresponding numbers were for smoking 20.1 vs 16.8 pp, obesity 9.9 vs 12.9 pp, sedentary physical activity level 10 vs 11.5 pp (p=0.027), systolic blood pressure 1.7 vs 1.7 mmHg, total cholesterol 0.2 mmol/L vs no difference (p&amp;lt;0.001), LDL cholesterol 0.1 mmol/L vs no difference (p&amp;lt;0.001), and total CVD risk 1.2 vs 0.9, respectively. No difference across educational levels and time regarding blood pressure or total- or LDL cholesterol in users of antihypertensives and lipid-lowering drugs was found, except for an educational difference in the first but not the second time period in female antihypertensive users. Conclusion We found a clinically relevant educational gap in CVD risk factors, with more favourable levels with higher education. Over time, the educational gap increased in physical activity in both sexes, and in total CVD risk in women. Further, the educational gap declined in blood lipids in both sexes, and in systolic blood pressure in women. While medication use seems to contribute to weaken the educational gradient in blood pressure and lipid levels, a stronger emphasis on lifestyle interventions is needed to reduce the educational inequalities in behavioural CVD risk factors.

CORRELATION BETWEEN INFLAMATORY CYTOKINES AND ANTHROPOLOGICAL PARAMETERS IN THE AGED POPULATION

Cytokines play an important role in regulating the immune response in the elderly population, and various studies indicate an inability to control systemic inflammation in the elderly, which may be a sign of ‘unsuccessful aging’. Thus, the evaluation of inflammatory cytokine profile in a healthy elderly population is a prerequisite for assessing the risk of developing the disease. The aim of the present study was to evaluate the level of cytokines - IL-6 and IL-18 in the healthy elderly population and to reveal their correlation with anthropological parameters. The results of our study shown that IL-18 levels were statistically significantly correlated with height in men and systolic blood pressure in women. IL-18 levels in the general population are reliably and strongly associated with IL-6 (r = 0.475; p = 0.001). Thus, based on our findings, evaluation of IL-6 and IL-18 concentrations can be used as biomarkers of “inflamaging”.

Impact of Yoga on Specific Risk Factors in Middle-Aged Women with Hypertension

This randomised controlled trial set intended to examine the results of yoga practises on Systolic BP and Total Cholesterol in hypertensive middle-aged women. Thirty middle-aged hypertensive women from the city of Chennai were recruited at random using a random group sample approach and were divided into two groups of 15 patients each (Experimental group and Control group). The hypothesis was that middle-aged hypertensive women's Systolic Blood Pressure and Total Cholesterol would differ significantly from those of the Control group as a result of their yoga practises. Prior to the start of training, a preliminary test was performed on a chosen dependent variable. The yoga practises of the experimental group lasted for 12 weeks, with each session lasting no more than an hour each morning. The control group was required to maintain a state of mild activity. After the training period ended, both groups were given a post test measuring the same dependent variables, including systolic blood pressure and total cholesterol. Analysis of Co-Variance (ANCOVA) was used to statistically compare the data from= each group. A 5% level of significance was chosen for the test. The study found that the Experimental group's yoga practises led to statistically significant improvements in comparison to the Control group in terms of some variables including Systolic Blood Pressure and Total Cholesterol. Therefore, the hypothesis was accepted with a 0.05 level of confidence. Therefore, it can be inferred that yoga activities help middle-aged hypertensive women keep their Systolic Blood Pressure in check and their Total Cholesterol levels low

Sex Differences in Post-exercise Hypotension, Ambulatory Blood Pressure Variability, and Endothelial Function After a Power Training Session in Older Adults.

Background: The efficacy of power training (PT) to acutely reduce blood pressure (BP) in participants with hypertension is controversial, and no studies have assessed the influence of sex on post-exercise hypotension and its mechanisms in older adults.Purpose: The aims of this secondary, exploratory analysis were to compare the effects of a single bout of PT on post-exercise hypotension, BP variability, and endothelial function between older men and women with hypertension.Methods: Twenty-four participants with hypertension (12 men and 12 women aged to >60 years old) took part in this crossover study and randomly performed two experimental sessions: power exercise training (PT) and non-exercising control session (Con). The PT protocol was composed of 3 sets of 8–10 repetitions of five exercises performed in the following order: leg press, bench press, knee extension, upright row, and knee flexion, using an intensity corresponding to 50% of one repetition maximal test (1RM) and 2-min intervals between sets and exercises. The concentric phase of exercises during each repetition was performed “as fast as possible,” while the eccentric phase lasted 1 to 2 s. During Con, the participants remained at seated rest on the same exercise machines, but without any exercise. Each protocol lasted 40 min. Office BP, flow-mediated dilatation (FMD), 24-h ambulatory BP, and the average real variability (ARV) of systolic and diastolic BP were assessed before and after experimental sessions.Results: Comparing PT with Con, a reduced office BP after exercise was found in men (systolic BP—average post 1 h: −14 mmHg, p < 0.001; diastolic BP—average post 1 h: −8 mmHg, p < 0.001) and only a reduced systolic BP in women (average post 1 h: −7 mmHg, p = 0.04). Comparing men and women, a reduced systolic BP (post 60': −15 mmHg, p = 0.048; average post 1 h: −7 mmHg, p = 0.046) and diastolic BP (post 60': −9 mmHg, p = 0.049) after the first hour were found in men. In relation to 24-h ambulatory BP, ARV, and FMD, no statistically significant differences were found between men and women.Conclusion: In older adults with hypertension, the office BP response after the experimental sessions was different in men and women, showing that the PT protocol is more effective to acutely reduce BP in men. Additionally, the mechanisms behind this reduction remain unclear. This finding suggests that sex cannot be combined to analyze post-exercise hypotension.Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT03615625.

Normotensive preterm delivery and maternal cardiovascular risk factor trajectories across the life course: The HUNT Study, Norway.

Preterm delivery (<37weeks) predicts later cardiovascular disease risk in mothers, even among normotensive deliveries. However, development of subclinical cardiovascular risk before and after preterm delivery is not well understood. We sought to investigate differences in life course cardiovascular risk factor trajectories based on preterm delivery history. The HUNT Study (1984-2008) linked with the Medical Birth Registry of Norway (1967-2012) yielded clinical measurements and pregnancy outcomes for 19806 parous women with normotensive first deliveries. Women had up to three measurements of body mass index, waist-to-hip ratio, blood pressure, lipids, non-fasting glucose, and C-reactive protein during follow up between 21years before to 41years after first delivery. Using mixed effects models, we compared risk factor trajectories for women with preterm vs term/postterm first deliveries. Trajectories overlapped for women with preterm compared with term/postterm first deliveries for all cardiovascular risk factors examined. For instance, the mean difference in systolic blood pressure in women with preterm first deliveries compared with those with term deliveries was 0.2mmHg (95% CI -1.8 to 2.3) at age 20 and 1.5mmHg (95% CI -0.5 to 3.6) at age 60. A history of preterm delivery was not associated with different life course trajectories of common cardiovascular risk factors in our study population. This suggests that the robust association between preterm delivery and cardiovascular end points in Norway or similar contexts is not explained by one or more commonly measured cardiovascular risk factors. Overall, we did not find evidence for a single cardiovascular disease prevention strategy that would reduce risk among the majority of women who had preterm delivery.

Association of serum uric acid, morning home blood pressure and cardiovascular risk factors in a population with previous prehypertension: a cross-sectional study

ObjectiveTo observe the changes in blood pressure (BP) over 10 years and to investigate current BP association to serum uric acid (SUA) levels and cardiovascular risk factors in the epidemiological...

The Effect of Oligopin Supplement on Systolic Blood Pressure in Women with Type 2 Diabetic Mellitus

The Effect of Oligopin Supplement on Systolic Blood Pressure in Women with Type 2 Diabetic Mellitus

Supernormal vascular aging — prevalence and determinants at population level (the ESSE-RF data)

Background. Arterial stiffness, which is a marker of vascular damage and cardiovascular disease independent predictor, can be used as an indicator of vascular aging. Vascular changes may occur in some individuals earlier than it comes according to chronological age (early vascular aging syndrome) or later (healthy aging). SUPERNOVA (supernormal vascular aging) is a new protective phenotype in which very low arterial stiffness values are recorded regardless of the level of risk factors exposure.Objective. To assess the prevalence of SUPERNOVA phenomenon and risk factors in St Petersburg population-based sample.Design and methods. The survey of 1600 St Petersburg residents aged 24-65 years was performed in terms of the epidemiological observation study ESSE-RF (2012-2013). Anthropometry and fasting blood sampling for lipids and glucose detection and blood pressure measurement according to standard methods were performed. Pulse wave velocity (PWV) assessed by SphygmoCor (Australia) was performed in 524 people. 485 participants were selected without cardiovascular complications history. The participants were divided by age into 5 groups: persons under 30 years, 30-39 years, 40-49 years, 50-59 years, 60 years and older. PWV &lt; 10th percentiles for healthy individuals PWV (Reference Values for Arterial Stability’s Collaboration, 2010) was detected as SUPERNOVA phenomenon in each age group. Mathematical and statistical data analysis was implemented using IBM SPSS Statistics 20.0.Results. SUPERNOVA phenomenon prevalence was 9,8 % (48 participants): 11,9 % women (32 participants) and 7,4 % men (16 participants). Among women systolic blood pressure (SBP) levels (p = 0,01) and body mass index (BMI) (p = 0,055) were significantly lower. Subjects with SUPERNOVA showed significantly lower SBP and diastolic blood pressure (DBP), BMI, glucose, triglycerides and lower prevalence of arterial hypertension (HTN), obesity, hypercholesterolemia and hypertriglyceridemia. In participants younger 30 years only obesity prevalence was significantly lower in respondents with SUPERNOVA, based on BMI criterion (p = 0,046). Participants aged 30-39 years showed no significant differences. In the group aged 40-49 years BMI (p = 0,02), abdominal obesity prevalence (p = 0,05), as well as SBP levels (p = 0,03) and DBP (p = 0,05) was significantly lower in individuals with SUPERNOVA. In the group aged 50-59 with SUPERNOVA significantly lower HTN prevalence (p = 0,03), glucose levels (p = 0,005) and BMI (p = 0,04) were found. In the older age group of 60-65 years subjects with SUPERNOVA have significantly lower levels of SBP (p = 0,014) and DBP (p = 0,014), as well as significantly lower prevalence of HTN (p = 0,03).Conclusions. At population level the phenomenon of supernormal vascular aging occurs in about 10 % without significant gender prevalence. HTN, obesity and metabolic factors are the determining factors of vascular aging. Ideal vascular health is associated with age-specific features.

“Cerrado” cashew (Anacardium othonianum Rizz.) juice improves metabolic parameters in women: A pilot study

Abstract This study aimed to evaluate the impact of 30-day “Cerrado” cashew juice consumption in women. “Cerrado” cashew juice was produced through enzymatic clarification after maceration of Anacardium othonianum pseudofruit. The “Cerrado” cashew juice was clarified, pasteurized, and evaluated for its chemical characteristics, and a daily intake of 400 mL was used in the pilot study of nine women. The “Cerrado” cashew juice showed high vitamin C content (30 mg 100 mL−1), and consumption of “Cerrado” cashew juice increases the recommended daily intake of manganese (56 %), zinc (22 %), iron (14 %), and copper (13 %). Consumption of “Cerrado” cashew juice improved the time to reach the maximum glucose value in the glycemic curve, the cholesterol levels (triglycerides, total and low-density lipoprotein cholesterol) and systolic blood pressure in women.

The Effect Of Home-Based Hypertension Screening On Blood Pressure Change Over Time In South Africa.

There is considerable policy interest in home-based screening campaigns for hypertension in many low- and middle-income countries. However, it is unclear whether such efforts will result in long-term population-level blood pressure improvements without more comprehensive interventions that strengthen the entire hypertension care continuum. Using multiple waves of the South African National Income Dynamics Study and the regression discontinuity design, we evaluated the impact of home-based hypertension screening on two-year change in blood pressure. We found that the home-based screening intervention resulted in important reductions in systolic blood pressure for women and younger men. We did not find evidence of an effect on systolic blood pressure for older men or on diastolic blood pressure for either sex. Our results suggest that home-based hypertension screening may be a promising strategy for reducing high blood pressure in low- and middle-income countries, but additional research and policy efforts are needed to ensure that such strategies have maximum reach and impact.

Effect of relaxation exercise on fasting blood glucose and blood pressure in gestational diabetes

Background Gestational diabetes is a growing problem worldwide, with risks for both the woman and the baby. Stress has been shown to be linked with diabetes, and therefore research is examining the effect of relaxation on blood pressure. Aim To assess the effect of relaxation on blood glucose and blood pressure in women with gestational diabetes mellitus. Methods This quasi-experimental study was performed with a sample of 80 participants. Fasting blood glucose and systolic and diastolic blood pressure were measured before and after the intervention, which was a 10-week programme of home mind-body and relaxation. Findings Both systolic blood pressure and fasting blood glucose in the control group were significantly higher (P&lt;0.001). Diastolic blood pressure in both groups was not found to be significantly different (P=0.151). Conclusions Relaxation exercises reduce fasting blood glucose and systolic blood pressure in women with gestational diabetes mellitus.

Norepinephrine intravenous prophylactic bolus versus rescue bolus to prevent and treat maternal hypotension after combined spinal and epidural anesthesia during cesarean delivery: a sequential dose-finding study.

As a relatively new drug in obstetrical anesthesia, norepinephrine is less likely to induce bradycardia and decrease cardiac output, which makes it a potential alternative to phenylephrine. The purpose of this study was to determine the optimal norepinephrine bolus dose needed to either prevent or reverse hypotension after the use of combined spinal and epidural (CSE) anesthesia in 90% of women during elective cesarean delivery (CD). Eighty women undergoing elective CD were randomly allocated into either a prophylactic group or a rescue group in this dose finding study. If the women's systolic blood pressure (SBP) was maintained above 80% of their baseline, the next patient had an 8/9th chance of receiving the same dose or a 1/9th chance of receiving a lower dose. If the patient's SBP was not maintained, a higher dose was used for next patient. The primary outcome was the successful use of the norepinephrine bolus dose to maintain SBP above 80% of the baseline until after delivery. Secondary outcomes included nausea, vomiting, breathlessness, dizziness, hypertension, bradycardia due to hypotension and supplemental use of atropine and norepinephrine, upper sensory level of anesthesia, umbilical vein (UV) blood gases, and 1- and 5-minute Apgar scores. The 90% effective dose (ED90) and 95% confidence interval (95% CI) were estimated using isotonic regression methods. The estimated ED90 of the norepinephrine prophylactic bolus was 10.85 µg (95% CI, 9.20-11.67 µg) and that of the norepinephrine rescue bolus was 12.3 µg (95% CI, 10.0-12.8 µg) using isotonic regression methods. For norepinephrine, either a prophylactic bolus dose of 11 µg or a rescue bolus dose of 12 µg was recommended for clinical practices.

Inulin Supplementation Reduces Systolic Blood Pressure in Women with Breast Cancer Undergoing Neoadjuvant Chemotherapy.

Introduction Breast cancer is the most frequently diagnosed malignancy in women, and comorbidities like hypertension and obesity diminish their quality of life and negatively affect their response to chemotherapy. Furthermore, inulin supplementation is associated with the reduction of cardiovascular diseases (CVD) risk. Objective To determine whether inulin supplementation prevents the elevation of blood pressure in women with breast cancer undergoing neoadjuvant therapy with cyclophosphamide and doxorubicin. Methods This was a randomized, double-blind placebo controlled trial which included women with early-stage breast cancer undergoing neoadjuvant therapy (n=38). Patients were randomly assigned to participate in two different groups to receive either 15 g of inulin or 15 g of placebo (maltodextrin) for 21 days. Body composition and blood pressure were evaluated before and after the supplementation period. Results Women in the inulin group showed a lower systolic blood pressure (SBP) after the supplementation (-4.21 mmHg, p<0.001). However, SBP increased in the placebo supplemented group. Diastolic blood pressure (DBP) nonsignificantly decreased in the inulin group. Inulin supplementation also increased BMI (p<0.001) but reduced BFP (p=0.288). Furthermore, confounding variables, such as BMI, baseline fasting glucose, age, menopause status, vomiting, constipation, and chronic medication did not have a statistical influence over the inulin effect on SBP. Conclusion Inulin supplementation reduces SBP and prevents increases in DBP in women with breast cancer. This could be an innovative nutraceutical approach to prevent hypertension present in women with this type of cancer at an early stage and may improve the quality of life of the patients and their prognostic development through chemotherapy. Trial Registration Number This trial is registered with ACTRN12616001532493.

Creatine kinase and blood pressure in women with a history of early-onset preeclampsia.

High plasma creatine kinase (CK) activity is associated with hypertension in the general and pregnant population. We hypothesize that women with a history of early-onset preeclampsia are prone to hypertension due to a high CK activity level. Nine to 16 years after pregnancy, serum CK activity and blood pressure were measured in 117 women with a history of early-onset preeclampsia and 50 women with a history of an uncomplicated pregnancy. CK activity levels of the two groups were compared using the Mann-Whitney U test. The association between CK activity and blood pressure was evaluated by means of multivariable regression analysis. There was no significant difference in median (interquartile range) CK activity between women with a history of early-onset preeclampsia and an uncomplicated pregnancy (59.00 [47.00-85.00] vs. 58.00 [46.50-75.25], respectively, p = 0.774). The association between CK and systolic blood pressure was significant in women with a pregnancy history of early-onset preeclampsia (regression coefficient [95% confidence interval]: 0.123 mmHg [0.020-0.226], p = 0.019), and a trend was found for diastolic blood pressure (p = 0.069). CK and blood pressure were not significantly associated in women with a history of an uncomplicated pregnancy. Median CK did not significantly differ between the two groups. Serum CK activity was significantly associated with systolic blood pressure in women with a history of early-onset preeclampsia. These data suggest that CK is not a predominant factor in the increased risk of hypertension in women with a history of early-onset preeclampsia.

The prone position in healthy pregnant women and in women with preeclampsia \u2013 a pilot study

BackgroundThe prone position is rarely used in medical settings in pregnancy. There is no published information about the prone position in women with preeclampsia. This study examined the feasibility and acceptability of the prone position in pregnant women, and the short-term effect of the prone position on blood pressure (BP) in term healthy pregnant women and in women with preeclampsia.MethodsAfter ethics approval, written consent and trial registration (ACTRN:12615000160538 registered 18/02/2015, date of first participant enrolled 03/03/2015), 50 healthy term pregnant women and 15 women with preeclampsia had BP, heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR), fetal heart rate (FHR) and comfort levels measured in two positions: left lateral, and prone. Measurements were after five minutes rest in each position.ResultsMean ± SD age, gestation and body mass index for healthy pregnant women was 33 ± 4.1 years, 38 ± 1.0 weeks and 27 ± 3.2 kg.m− 2 and for women with preeclampsia was 32 ± 4.7 years, 36 ± 3.4 weeks, 31 ± 5.6 kg.m− 2 respectively. No clinically significant changes occurred in healthy pregnant women in the prone position. Systolic BP was reduced in the prone position in women with preeclampsia (P = 0.019, mean difference − 6.6 mmHg, 95% confidence interval − 11.9 to − 1.3 mmHg). 33% of women with preeclampsia experienced a 10 mmHg or greater reduction in systolic BP in the prone position. 42% of healthy pregnant women and 47% of women with preeclampsia preferred the prone position to lateral.ConclusionsThis is the first study to examine the prone position in women with preeclampsia. For short periods of time the prone position is feasible and comfortable in pregnant women including those at term. The prone position may reduce systolic BP in women with preeclampsia without obvious adverse effects. Larger studies with women lying for longer periods in the prone position are required. Pregnancy should not be a contraindication to the prone position for short periods of time.Trial registrationACTRN:12615000160538