Systolic Blood Pressure Levels Research Articles

Vitamin D deficiency and the vitamin D receptor (VDR) gene polymorphism rs2228570 (FokI) are associated with an increased susceptibility to hypertension among the Bangladeshi population.

Vitamin D receptor (VDR) gene is implicated in hypertension vulnerability due to its role in regulating the renin-angiotensin system (RAS) and blood pressure. In this case-control study, a carefully selected cohort of 111 hypertensive individuals and 100 healthy controls underwent serum analysis using HPLC to measure 25-hydroxy vitamin D levels. Polymorphic variations in the VDR gene were detected and characterized using the PCR-RFLP method. At first, lower 25-hydroxy vitamin D levels were observed in hypertensive individuals compared to controls (p<0.001). The genotype frequency of the VDR gene TaqI showed no significant difference between cases and controls (p>0.05). Similarly, no significant difference was found in the VDR gene BsmI genotype frequency between hypertensive patients and controls (p>0.05). However, a statistically significant distinction was observed in the VDR gene FokI genotype frequency between cases and controls (p<0.01). The odds ratios for FokI genotypes (CC, CT, TT, and CT+TT) were 1.0, 0.590, 1.566, and 0.963, respectively. Furthermore, serum 25-hydroxy vitamin D levels were significantly higher in control subjects compared to hypertensive patients across all genotypes of VDR (p<0.001). Hypertensive patients, excluding those with the FokI VDR gene CC genotype, exhibited significantly higher systolic blood pressure levels compared to the control group (p<0.05). Similarly, hypertensive subjects displayed elevated diastolic blood pressure levels compared to the control group (p<0.001). Overall, the results suggest the presence of a potential inverse correlation between serum 25-hydroxy vitamin D levels and hypertension. The association analysis conducted indicated that there is no significant association between TaqI and bsmI genotypic variants and the risk of developing hypertension. However, it was observed that VDR gene polymorphisms do have a clear association with hypertension susceptibility, as evidenced by the significantly higher occurrence of FokI genotypic variants in hypertensive patients. Our study therefore introduces the possibility of utilizing 25-hydroxy vitamin D deficiency and VDR gene polymorphisms as a biomarker for hypertension.

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study.

To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Accidental Hypothermia in the Largest Emergency Hospital in North-Eastern Romania.

Accidental hypothermia (AH) presents a significant mortality risk, even in individuals with good health. Early recognition of the parameters associated with negative prognosis could save more lives. This was a pilot, retrospective observational study, conducted in the largest Emergency Hospital in North Eastern Romania, which included all patients with AH (defined as body temperature below 35°C), hospitalized and treated in our hospital between 2019 and 2022. A total of 104 patients with AH were included in our study, 90 of whom had data collected and statistically analyzed. The clinical, biological, and therapeutic parameters associated with negative outcomes were represented by a reduced GCS score (p=0.024), diminished systolic and diastolic blood pressure (p=0.007 respectively, 0.013), decreased bicarbonate (p=0.043) and hemoglobin levels (p=0.002), the presence of coagulation disorders (p=0.007), as well as the need for administration of inotropic or vasopressor medications (p=0.04). In this pilot, retrospective, observational study, the negative outcomes observed in patients with AH hospitalized in the largest Emergency Hospital in North-Eastern Romania were associated with several clinical, biochemical, and therapeutic factors, which are easy to identify in clinical practice. Recognizing the significance of these associated factors empowers healthcare practitioners to intervene at an early stage to save more lives.

Correlation Between HbA1c and Body Mass Index Among Patients with High Lipid Profile Attending Johns Hopkins Aramco Healthcare Hospital in Saudi Arabia

BACKGROUND AND OBJECTIVES: Dyslipidemia is a modifiable risk factor for cardiovascular diseases, diabetes, and stroke. The primary objective of this study was to examine the relationship between HbA1C and body mass index (BMI) among patients with high lipid profiles. METHODS: This retrospective, hospital-based study was conducted at Johns Hopkins Aramco Healthcare Facilities. Data were extracted from medical health records and included demographics, lipid profiles, and HBA1c measurements. The study included 2368 non-diabetic participants, and DATAtab was used to analyze the data. RESULTS: The participants were 57.05% male and 78.42% Saudi. The mean age was 41.48±12.1 years, and the mean body mass index (BMI) was 28.44±5.53. There was a statistically significant relationship between the use of lipid lowering medicine and HbA1c (P&lt;0.001). There was a very weak positive but statistically significant relationship between HbA1c and BMI (r = 0.18, P&lt;0.001). HbA1c and systolic blood pressure appeared to have a statistically significant positive association (r = 0.16, P&lt; 0.001). There was no correlation between HbA1c and low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or diastolic blood pressure. There was an inverse correlation between HbA1c and high-density lipoprotein cholesterol (HDL-C) (r = -0.11, P&lt; 0.001). Regression was performed using a linear multivariable analysis with HbA1c as the dependent variable, and age (B 0.192, P&lt;0.001), BMI (B 0.119, P&lt;0.001), HDL (B -0.058, P&lt;0.005), triglyceride (B 0.093, P&lt;0.001), lipid-lowering medication (B 0.104, P&lt;0.001), systolic BP (B 0.060, P&lt; 0.003) as independent variables. CONCLUSION: The results indicated that HbA1c is linked to BMI, age, systolic blood pressure, triglycerides, and HDL-C levels. There was no correlation between HbA1c and LDL-C, TC, and diastolic blood pressure.

Association between baseline office blood pressure level and the incidence and development of long-term frailty in the community-dwelling very elderly with hypertension.

Frailty is the most important risk factor causing disability in the elderly. Hypertension is one of the most common chronic diseases in the elderly and is closely related to frailty, but there is still controversy about the association between blood pressure and frailty. To explore the association between baseline blood pressure level and the incident and development of long-term frailty in the community-dwelling very elderly (i.e., over 80 years old [1]) with hypertension, in order to provide a basis for scientific blood pressure management of very elderly hypertension. In this study, very elderly hypertensive patients who received comprehensive geriatric assessment from January to June 2019 and with complete data were included, and follow-up was conducted from January 1 to February 14, 2023. A total of 330 very elderly individuals with hypertension were enrolled in this study. FRAIL scale was used to evaluate frailty. Binomial logistic regression analysis was used to calculate the OR and 95%CI between baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) levels and long-term incident and development of frailty. The dose-response relationship between baseline office SBP, DBP or PP levels and incident frailty and its development was analyzed by Generalized Additive Model (GAM) using smooth curve fitting and threshold effect analysis. Smooth curve fitting and threshold effect analysis showed that the relationship between baseline office SBP level and incident frailty was U-shaped, with the nadir of the U-shaped curve at 135 mmHg after adjustment. Baseline office SBP, PP level and development frailty was U-shaped and the nadir was 140 mmHg and 77 mmHg. In the community-dwelling very elderly with hypertension, baseline office SBP level had a relationship with long-term incident frailty and its development and PP level had a relationship with long-term development of frailty.

Effect of different alpha-receptor antagonists on metabolic parameters: a head-to-head comparison.

Although it is known that alpha-adrenergic receptor antagonists have positive effects on metabolic parameters such as glucose metabolism, lipid profile, and insulin sensitivity, it is unclear whether this is a class effect. Tamsulosin is reported to have adverse effects on glucose metabolism and insulin resistance, and this may be because of its lack of glycolysis-enhancing effect compared with other alpha-adrenergic receptor antagonists with glycolysis-enhancing effects such as doxazosin, terazosin, and alfuzosin. The aim of this study was to compare the effect of tamsulosin on metabolic parameters with another alpha-1 adrenergic receptor antagonist, doxazosin. In this prospective, observational, controlled, 12-week clinical study, a total of 60 male patients aged ≥ 40years who were first started on tamsulosin (n = 30; 0.4mg/day, oral; mean age, 59.20 ± 8.97years) or doxazosin (n = 30; 4 or 8mg/day, oral; mean age, 58.50 ± 8.93years) for benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) were enrolled. The groups were compared according to the changes in anthropometric and biochemical parameters (glycemia, lipid profile, and insulin sensitivity) at the end of treatment. In intragroup analyses, systolic blood pressure, diastolic blood pressure, total cholesterol, and HbA1c levels decreased significantly in the doxazosin group compared with baseline (p < 0.05 for all), while no significant change was observed in the tamsulosin group. In comparisons between groups, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol levels showed a significant decrease in the doxazosin group compared with the tamsulosin group (percent change: - 6.68 ± 13.08 vs. 0.53 ± 11.02, p = 0.025; - 3.63 ± 9.56 vs. 4.02 ± 10.86, p = 0.005; and - 5.62 ± 18.18 vs. 5.24 ± 15.42, p = 0.015, respectively). Although these results do not support previous findings that tamsulosin has adverse effects on metabolic parameters, they suggest that doxazosin treatment may be a reason for preference in patients with BPH or LUTS accompanied by metabolic disorder.

Association between trajectories of systolic blood pressure and frailty outcome in middle-aged and older adults

ObjectivesThe association between blood pressure and frailty outcome in the middle-aged and older population remains controversial. This study aimed to examine the relationship between trajectories of systolic blood pressure (SBP) and new-onset frailty. DesignCohort study with a 7-year follow-up. SETTING AND PARTICIPANTSData were derived from 4 waves (2011, 2013, 2015 and 2018) of the China Health and Retirement Longitudinal Study and 6168 participants aged ≥45 years were included in the study. MethodsThe frailty index (FI) was constructed based on 40 scored items, with FI ≥ 0.25 defined as frailty. We identified the 5-year trajectory of SBP by latent class trajectory modeling. The association between SBP trajectories and frailty was explored based on hazard ratios (HR) by four Cox proportional hazards models. Furthermore, we also investigated the relationship between mean SBP and systolic blood pressure variability (SBPV) and frailty. Results6168 participants were included in this study with a mean age of 59 years. We identified five trajectories based on SBP, which are maintained low-stable SBP (T0), moderate-stable SBP (T1), remitting then increasing SBP (T2), increasing then remitting SBP (T3), and remaining stable at high SBP levels (T4). During the 7-year follow-up period, frailty outcome occurred in 1415 participants. After adjusting for other confounders, the two trajectories labeled “T2” and “T4” were associated with a higher risk of frailty compared with T0. In addition, elevated SBP and increased SBPV were associated with risk of frailty. ConclusionsHigher risk of frailty occurred in two trajectories, remitting then increasing and remaining stable at high SBP levels, were associated with a relatively higher risk of frailty.

Renal function and cardiovascular risk in overweight patients

Background. Currently, in most countries of the world, there is a tendency for an annual increase in the proportion of overweight people (OW). Studies performed in various age groups and devoted to the relationship of OW with the functional state of the kidneys show contradictory results.The aim: to study the functional state of the kidneys and the prevalence of risk factors for cardiovascular complications in OW, taking into account gender differences.Patients and Methods. A cross–sectional single-center study was conducted with the participation of 154 patients (73 men and 81 women) with body mass index (BMI) 25.0–29.9 kg/m2), whose average age was 53.9±12.6 years. Anthropometric and biochemical parameters were evaluated in all patients, the functional state of the kidneys (according to serum creatinine and cystatin C) was studied, and an analysis of cardiovascular risk factors was carried out.Results. Analysis of excretory renal function by cystatin C showed that in most of the examined individuals, regardless of gender, there was a decrease in eGFR to CKD stages 2 and 3a. OW among men was statistically significantly more often associated with hypertriglyceridemia (32.8 %), tachycardia (38.3 %) and atherosclerotic lesion of the carotid arteries (24.6 %). In the subgroup of women with ischemic heart disease, the average age, the content of low-density lipoproteins, the double product index, the frequency of hypercholesterolemia, dyslipidemia and hypertrophy of the left ventricle (LVH), mainly of the eccentric type, were significantly higher, and the hemoglobin content and the number of red blood cells were significantly lower. Significant correlations of eGFR with concentrations of hemoglobin and C-reactive protein, as well as with the value of the left ventricular myocardial mass index (LVMI) were found in men with ischemic heart disease. Correlations of eGFR with the levels of systolic, mean, pulse and central blood pressure, index of functional changes, LDL-C, triglycerides, hemoglobin, fibrinogen, metabolic index, as well as LVMI were found in women with ischemic heart disease. The value of LVH in women was significantly associated with the level of central blood pressure, cystatin C, LDL, hemolobin, fibrinogen, metabolic index, and eGFR. In the general sample of patients with ischemic heart disease, the content of serum cystatin C was positively correlated with LVH and inversely with eGFR calculated by cystatin C. There was a weak negative relationship between the level of central arterial pressure and eGFR by cystatin C.Conclusion. Evaluation of excretory renal function, according to cystatin C and serum creatinine, in individuals with ISM has a higher diagnostic value than evaluation using methods based on the use of serum creatinine alone. In males, the presence of OW is associated with tachycardia, hypertriglyceridemia, a significant decrease in GFR and an increase in the frequency of atherosclerotic changes in the carotid arteries. The following cardiovascular risk factors are associated in women with ischemic heart disease: old age, anemia, increased fibrinogen concentration, dyslipidemia, increased values of the double product index, metabolic index and index of functional changes, as well as hemodynamic and LVH parameters.

Associations of 50 modifiable risk factors with atrial fibrillation using Mendelian randomization analysis.

Substantial focus has been placed on atrial fibrillation (AF) treatment and associated stroke prevention rather than preventing AF itself. We employed Mendelian randomization (MR) approach to examine the causal relationships between 50 modifiable risk factors (RFs) and AF. Instrumental variables for genetically predicted exposures were derived from corresponding genome-wide association studies (GWASs). Summary-level statistical data for AF were obtained from a GWAS meta-analysis (discovery dataset, N = 1,030,836) and FinnGen (validation dataset, N = 208,594). Univariable and multivariable MR analyses were performed, primarily using inverse variance weighted method with a series of robust sensitivity analyses. Genetic predisposition to insomnia, daytime naps, apnea, smoking initiation, moderate to vigorous physical activity and obesity traits, including body mass index, waist-hip ratio, central and peripheral fat/fat-free mass, exhibited significant associations with an increased risk of AF. Coffee consumption and ApoB had suggestive increased risks. Hypertension (odds ratio (OR) 95% confidence interval (CI): 5.26 (4.42, 6.24)), heart failure (HF) (OR 95% CI, 4.77 (2.43, 9.37)) and coronary artery disease (CAD) (OR 95% CI: 1.20 (1.16, 1.24)) were strongly associated with AF, while college degree, higher education attachment and HDL levels were associated with a decreased AF risk. Reverse MR found a bidirectional relationship between genetically predicted AF and CAD, HF and ischemic stroke. Multivariable analysis further indicated that obesity-related traits, systolic blood pressure and lower HDL levels independently contributed to the development of AF. This study identified several lifestyles and cardiometabolic factors that might be causally related to AF, underscoring the importance of a holistic approach to AF management and prevention.

Expansion of Psychosocial Distress in Nurses Working in Hemodialysis During Exposure to COVID-19 Pandemic in Bulgaria

Abstract A new type of virus, SARS-CoV-2, has spread globally throughout the world. The COVID-19 epidemic rapidly spread worldwide. The health care system, society and medical professionals have prepared to adapt, train and resist the increased psychosocial pressure. In this situation, the role and place of medical professionals has become noticeably more prominent, and the psychosocial stress of the work environment has increased its impact – progressing to high levels of harmful intensity towards the medical professionals. Focusing within the borders of Bulgaria, it can be argued that the initial two waves of high levels of COVID-19 prevalence were difficult and critical to overcome. The aim of our study is to investigate the impact of psychosocial stress on the functional status examined with the response of arterial blood pressure of nurses, practicing long-term care in hemodialysis clinics and centers during exposure to COVID-19 pandemic. A study was conducted on the subjective assessment of psychological and social risk factors, and arterial systolic and diastolic blood pressure in 2018-2019 (pre-COVID-19 period) and 2020 (COVID-19 period), respectively. The methods used were the NIOSH questionnaire – to assess psychosocial stress at work and to measure blood pressure with a sphygmomanometer. The results showed that the expansion of psychosocial risks from the work environment impacted on the functional status of nurses, with an increase in the level of social support and systolic blood pressure during the COVID-19 compared to the pre-COVID-19 period, and a decrease in the level of control when comparing the same periods. We will monitor and observe these effects with concern in order to respond in a timely manner with effective and practical strategies, policies and programs to counter and prevent psychosocial stress in the workplace. One of the outlined guiding goals and trends for this will be to both preserve and prolong the work life of nurses and to reposition them as a key and significant group for the healthcare system.

Relationship between sleep quality and blood pressure level in nurses performing shift work

Abstract Objective The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical departments and to establish possible relationships between level of blood pressure (BP) and quality of sleep. Methods A total of 20 nurses of the therapeutic departments and 20 nurses of the surgical departments were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). BP was measured according to the standard protocol using the Korotkoff method; a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m. and 10:30 a.m. The average value for the 2 indicators was calculated. The diagnosis of essential arterial hypertension (AH) was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension (2018). Results The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality; this was true in respondents of both the surgical and therapeutic profiles. However, it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments. Moreover, poor sleep quality was associated with AH, which was diagnosed in 65% of the nurses of the therapeutic departments and 45% of the nurses of the surgical departments, that is, in almost all of the subjects. Herewith, in the nurses of the therapeutic departments, the level of systolic BP exceeded that of the nurses of the surgical departments. Conclusions Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work. Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.

The Level of Leptin in the Blood of Patients with Chronic Obstructive Pulmonary Disease and its Correlations with the Levels of Clinical, Functional and Anamnestic Indicators

Leptin, a hormone produced by white adipose tissue and recognised as an inflammatory biomarker, has an undefined role in the progression of chronic obstructive pulmonary disease (COPD). Objective — to evaluate the leptin level and its correlations with the levels of clinical, functional and anamnestic indicators in COPD patients. Materials and methods. This study employed a case-control design involving 42 patients experiencing acute exacerbation of COPD and 20 control subjects. The patients were examined according to the standard protocol. Additionally, the examination included ultrasonic scanning of the abdominal cavity, evaluation of the serum leptin level, scoring of the anxiety and depression and quality of life. Results and discussion. It was revealed that hyperleptinemia in the patients with acute exacerbation of COPD occurred significantly more frequently than in the healthy persons ((73.8 ± 6.8) vs (40.0 ± 11.0) %; р &lt; 0.05). Besides, the COPD patients manifested increased leptin levels much more frequently than normal levels ((73.8 ± 6.8) vs (26.2 ± 6.8) %; р &lt; 0.01). Hyperleptinemia was found to co-occur with severe COPD cases belonging to E clinical group ((51.6 ± 9.0) vs (18.2 ± 11.6) % in group with normal leptin level; р &lt; 0.05). Kendall correlation analysis established that elevated circulating leptin levels were associated with an increased body mass index (τ = 0.3; р = 0.02), female gender (τ = 0.3; р = 0.01), non-smoking history (τ = – 0.2; р = 0.03), stronger manifestation of such symptoms as shortness of breath (τ = 0.3; р=0.01), disturbed home (τ = 0.3; р = 0.002) and out-of-home activities (τ = 0.3; р = 0.02) and lack of energy (τ = 0.3; р = 0.01). It also correlated with increased severity of pulmonary insufficiency (τ = 0.3; р = 0.003) and decreased forced vital capacity (τ = – 0.2; р = 0.04), elevated systolic blood pressure (τ = 0.2; р = 0.02), elevated cholesterol (τ = 0.3; р = 0.01) and β-lipoproteins levels (τ = 0.2; р = 0.04), pronounced depression (τ = 0.3; р = 0.002) and lowered quality of life (τ = 0.3; р = 0.01). Сonclusions. COPD patients with elevated leptin levels manifest not only with an increased body weight, but also with arterial hypertension, disturbed lipid metabolism, more pronounced pulmonary insufficiency, depressive disorders and lowered life quality with more severe subjective respiratory symptoms.

Portrait of Metabolic Syndrome by Gender in A Rural Area of Gowa Regency

Metabolic syndrome is an important indicator in efforts to control non-communicable diseases. The incidence of metabolic syndrome is directly proportional to the incidence of obesity while the prevalence of metabolic syndrome varies based on sociodemographic characteristics and lifestyle. Efforts to identify metabolic syndrome in the community are a crucial step to identify early the potential for hypertension, coronary heart disease, stroke and diabetes mellitus. This study aims to identify components of metabolic syndrome based on gender. Cross sectional study is the research design that underlies data collection on risk factors for metabolic syndrome which is carried out through interviews and measurements of height, weight, waist circumference, blood pressure and cholesterol levels using NCEP-III criteria as the basis for identifying metabolic syndrome. Data analysis used the Chi-Square test. The metabolic syndrome component in the form of obesity is identified in men and women using different indicators. Both men and women have experienced increases in systolic blood pressure and cholesterol levels. A history of smoking was the only risk factor for metabolic syndrome with a statistically significant difference in proportion between men and women. Behavioral modifications such as eating patterns, rest, and others according to the guidance of the Koran and hadith are needed to minimize the incidence of metabolic syndrome.&#x0D;

Correlation Between HbA1c and Body Mass Index Among Patients with High Lipid Profile Attending Johns Hopkins Aramco Healthcare Hospital in Saudi Arabia

BACKGROUND AND OBJECTIVES: Dyslipidemia is a modifiable risk factor for cardiovascular diseases, diabetes, and stroke. The primary objective of this study was to examine the relationship between HbA1C and body mass index (BMI) among patients with high lipid profiles. METHODS: This retrospective, hospital-based study was conducted at Johns Hopkins Aramco Healthcare Facilities. Data were extracted from medical health records and included demographics, lipid profiles, and HBA1c measurements. The study included 2368 participants, and DATAtab was used to analyse the data. RESULTS: The participants were 57.05% male and 78.42% Saudi. The mean age was 41.48±12.1 years, and the mean body mass index (BMI) was 28.44±5.53. There was a statistically significant relationship between the use of lipid lowering medicine and HbA1c (P&lt;0.001). There was a very weak positive but statistically significant relationship between HbA1c and BMI (r = 0.18, P&lt;0.001). HbA1c and systolic blood pressure appeared to have a statistically significant positive association (r = 0.16, P&lt; 0.001). There was no correlation between HbA1c and low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or diastolic blood pressure. There was an inverse correlation between HbA1c and high-density lipoprotein cholesterol (HDL-C) (r = -0.11, P&lt; 0.001). Regression was performed using a linear multivariable analysis with HbA1c as the dependent variable, and the age (B 0.192, P&lt;0.001), BMI (B 0.119, P&lt;0.001), HDL (B -0.058, P&lt;0.005), Triglyceride (B 0.093, P&lt;0.001), lipid lowering medication (B 0.104, P&lt;0.001), systolic BP (B 0.060, P&lt; 0.003) as independents variables. CONCLUSION: The results indicated that HbA1c is linked to BMI, age, systolic blood pressure, triglycerides, and HDL-C levels. There was no correlation between HbA1c and LDL-C, TC, and diastolic blood pressure.

The Relationship of Perioperative Inadvertent Hypothermia with Anxiety and Comfort.

The study aimed to investigate the relationship of perioperative inadvertent hypothermia with anxiety and thermal and general comfort in surgical patients. Inadvertent perioperative hypothermia occurs after surgery and affects many patient outcomes. However, the relationship between hypothermia and anxiety has been given little attention. The research is of descriptive type. A total of 117 surgical patients who met the inclusion criteria were sampled and divided into two groups: hypothermic (n = 54) and normothermic (n = 63). Patients undergoing surgery were monitored for body temperature, systolic and diastolic blood pressure, heart rate, pain intensity, anxiety (Numeric Rating Scale [NRS] and State Anxiety Scale [SAI]), and comfort (Perianesthesia Comfort Questionnaire) levels. The groups were similar in terms of descriptive characteristics (p > 0.05). Among the patients undergoing surgical intervention, 46.1% were hypothermic. Compared with the normothermic group, the hypothermic group had significantly lower body temperature until the second postoperative hour, lower thermal comfort score until the third postoperative hour, and higher heart rate and anxiety (NRS) score until the first postoperative day. Furthermore, there was a significant difference between the groups in terms of pain intensity up to the first 30 minutes after surgery (p < 0.05). Moreover, there was no significant difference between the groups in terms of pre and postoperative day one anxiety (SAI) and Periantesthesia Comfort Scale mean scores (p > 0.05). The study findings showed that hypothermia affected thermal comfort up to the first 3 hours after surgery, pain intensity up to the first 30 minutes, and heart rate and anxiety (NRS) levels up to the first day.

Correlation between systolic blood pressure and mortality in heart failure patients with hypertension.

The correlation between systolic blood pressure (SBP) and mortality in hypertensive patients with different phenotypes of heart failure (HF) has not been adequately studied, and optimal blood pressure control targets remain controversial. To explore the link between SBP and prognosis in all or three ejection fraction (EF) phenotypes of HF patients with hypertension. We analyzed 1279 HF patients complicated by hypertension in a retrospective cohort. The SBP <130 mmHg group included 383 patients, and the SBP ≥130 mmHg group included 896 patients. The major end point was all-cause mortality. Of the 1279 study patients, with a median age of 66.0 ± 12.0 years, 45.3% were female. The proportions of the three subtypes of heart failure complicated with hypertension (HFrEF, HEmrEF, and HFpEF) were 26.8%, 29.3%, and 43.9%, respectively. During the 1-year follow-up, 223 patients experienced all-cause death, and 133 experienced cardiovascular death. Restricted cubic splines showed that the risk of all-cause and cardiovascular death increased gradually as the SBP level decreased in patients with HFrEF and HFmrEF. Furthermore, the multivariate Cox proportional hazards model revealed that SBP <130 mmHg was also associated with an increased risk of all-cause death [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.23-5.20, P = 0.011] and cardiovascular death (HR 1.91, 95% CI 1.01-3.63, P = 0.047) in HFrEF patients. A trend toward increased risk was observed among HFmrEF patients, but it was not statistically significant. This trend was not observed in HFpEF patients. In HFrEF patients, SBP <130 mmHg was associated with an increased risk of all-cause and cardiovascular mortality. A trend toward increased risk was observed among HFmrEF patients, but not among HFpEF patients.

Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid-Femoral Pulse Wave Velocity in Patients with Kidney Transplantation.

Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and mortality. This study aimed to assess the correlation between serum PAG levels and AS in kidney transplantation (KT) patients, potentially uncovering new insights into the cardiovascular risks in this population. In this study, 100 KT patients were included. Carotid-femoral pulse wave velocity (cfPWV) was measured, and patients with cfPWV > 10 m/s were categorized as the AS group. Serum PAG levels were assessed using liquid chromatography-tandem mass spectrometry. Thirty KT patients (30.0%) exhibited AS, with higher percentages of diabetes mellitus, older age, and elevated levels of systolic blood pressure, serum fasting glucose, and PAG than the control group. After adjusting for factors significantly associated with AS by multivariate logistic regression analysis, serum PAG, age, fasting glucose levels, and systolic blood pressure were independent factors associated with AS. Furthermore, PAG levels had a negative correlation with the estimated glomerular filtration rate and a positive correlation with cfPWV values. Serum PAG levels are positively associated with cfPWV values and are a biomarker of AS in KT patients.

The impact of telehealth education on self-management in patients with coexisting type 2 diabetes mellitus and hypertension: a 26-week randomized controlled trial.

The prevalence of coexisting type 2 diabetes mellitus and hypertension is increasing globally and posing significant health challenges. Effective self-management is crucial for controlling the disease and preventing complications. Telehealth education has emerged as a promising approach to enhancing self-management. This study aimed to investigate the effects of telehealth education on glycolipid metabolism, blood pressure, and self-management in patients with coexisting type 2 diabetes mellitus and hypertension. This study included 174 patients diagnosed with type 2 diabetes and hypertension from October 2022 to March 2023 at the 900th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army. The patients were randomly assigned to the control group or the telehealth education group. The control group received conventional diabetes education including diet and exercise guidance, while the telehealth education group received additional online education through the WeChatapplication. Both groups were followed up for 26weeks and the changes in glycolipid metabolism, blood pressure, and self-management were compared between the groups. After 26weeks of intervention, the telehealth education group showed statistically significant reductions in weight, body mass index, fasting blood glucose, 2h postprandial blood glucose, and hemoglobin A1c compared to the control group (P < 0.05). The telehealth education group also exhibited a significant decrease in systolic blood pressure and low-density lipoprotein-C level (P < 0.05). The Summary of Diabetes Self-Care Activities score, which reflects the level of diabetes self-management, demonstrated that the telehealth education group had a significantly better total score as well as superior scores in all five sub-categories (diet, blood glucose testing, medication use, and foot care) compared to the control group (P < 0.05). Our findings confirmed that telehealth education effectively enhanced the self-management capabilities of patients with coexisting type 2 diabetes and hypertension, leading to better glycolipid and blood pressure control. The use of telehealth education may potentially improve the interaction between medical staff and patients in the management of chronic diseases.

Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities

Hypertension remains a leading factor associated with cardiovascular disease, and demographic and socioeconomic disparities in blood pressure (BP) control persist. While advances in digital health technologies have increased individuals' access to care for hypertension, few studies have analyzed the use of digital health interventions in vulnerable populations. To assess the association between digital health interventions and changes in BP and to characterize tailored strategies for populations experiencing health disparities. In this systematic review and meta-analysis, a systematic search identified studies evaluating digital health interventions for BP management in the Cochrane Library, Ovid Embase, Google Scholar, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases from inception until October 30, 2023. Included studies were randomized clinical trials or cohort studies that investigated digital health interventions for managing hypertension in adults; presented change in systolic BP (SBP) or baseline and follow-up SBP levels; and emphasized social determinants of health and/or health disparities, including a focus on marginalized populations that have historically been underserved or digital health interventions that were culturally or linguistically tailored to a population with health disparities. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Two reviewers extracted and verified data. Mean differences in BP between treatment and control groups were analyzed using a random-effects model. Primary outcomes included mean differences (95% CIs) in SBP and diastolic BP (DBP) from baseline to 6 and 12 months of follow-up between digital health intervention and control groups. Shorter- and longer-term follow-up durations were also assessed, and sensitivity analyses accounted for baseline BP levels. A total of 28 studies (representing 8257 participants) were included (overall mean participant age, 57.4 years [range, 46-71 years]; 4962 [60.1%], female). Most studies examined multicomponent digital health interventions incorporating remote BP monitoring (18 [64.3%]), community health workers or skilled nurses (13 [46.4%]), and/or cultural tailoring (21 [75.0%]). Sociodemographic characteristics were similar between intervention and control groups. Between the intervention and control groups, there were statistically significant mean differences in SBP at 6 months (-4.24 mm Hg; 95% CI, -7.33 to -1.14 mm Hg; P = .01) and SBP changes at 12 months (-4.30 mm Hg; 95% CI, -8.38 to -0.23 mm Hg; P = .04). Few studies (4 [14.3%]) reported BP changes and hypertension control beyond 1 year. In this systematic review and meta-analysis of digital health interventions for hypertension management in populations experiencing health disparities, BP reductions were greater in the intervention groups compared with the standard care groups. The findings suggest that tailored initiatives that leverage digital health may have the potential to advance equity in hypertension outcomes.

Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study.

To examine whether vasomotor symptoms (VMS) and migraine headaches, hypothesized to be vasoactive conditions, are associated with greater risk for cardiovascular disease (CVD) events including strokes. We performed a secondary data analysis of a subset of women (n = 1,954) in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based cohort, which began data collection at 18 to 30 y of age. We examined whether migraine headaches and VMS trajectories (characterized as minimal, increasing, and persistent) at CARDIA year 15 examination were associated with higher risk of CVD events and stroke (both ischemic and hemorrhagic) using Cox proportional hazards regression models and adjustment for traditional CVD risk factors (age, cigarette use, and levels of systolic and diastolic blood pressure, fasting glucose, high- and low-density cholesterol, and triglycerides) and reproductive factors. Among women with minimal VMS (n = 835), increasing VMS (n = 521), and persistent VMS (n = 598), there were 81 incident CVD events including 42 strokes. Women with histories of migraine and persistent VMS had greater risk of CVD (hazard ratio [HR], 2.25; 95% CI, 1.15-4.38) after adjustment for age, race, estrogen use, oophorectomy, and hysterectomy compared with women without migraine histories and with minimal/increasing VMS. After adjustment for CVD risk factors, these associations were attenuated (HR, 1.51; 95% CI, 0.73-3.10). Similarly, women with histories of migraine and persistent VMS had greater risk of stroke (HR, 3.15; 95% CI, 1.35-7.34), but these associations were attenuated after adjustment for CVD risk factors (HR, 1.70; 95% CI, 0.66-4.38). Migraines and persistent VMS jointly associate with greater risk for CVD and stroke, although risk is attenuated with adjustment for traditional CVD risk factors.