Systolic Blood Pressure Measurements Research Articles

Effects of pre-pregnancy body mass index on cardiometabolic biomarkers in pregnant emirati women

BackgroundTo study effect of pregnancy on obese women’s maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.MethodsThis cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.ResultsWe enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.ConclusionThis study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.

Variability in cardiometabolic parameters and all-cause and cause-specific mortality in older adults: evidence from 2 prospective cohorts.

To assess the individual and joint associations of variability in multiple cardiometabolic parameters with mortality risk across older populations. A total of 51,551 Chinese elderly participants (aged ≥60 years) with ≥3 measurements of systolic blood pressure (SBP), visceral adiposity index (VAI), fasting blood glucose (FBG) and low-density lipoprotein cholesterol (LDL-C) during 2018-2022 were included. Variability metrics included standard deviation, coefficient of variation, average real variability and variability independent of the mean (VIM, used in primary analysis). Participants were classified based on the number of high-variability (highest quartile of variability) parameters into four categories: with 0, 1, 2 and 3-4 high-variability cardiometabolic parameters. Cox regression analyses were performed in 2024. Findings were then externally validated using the Health and Retirement Study (HRS, wave 8-15). Higher SBP, VAI, FPG and LDL-C variability were associated with greater all-, cardiovascular- and other-cause mortality risk. Compared with subjects with no high-variability parameters measured as the VIM, the hazard ratios (95% confidence interval) of all-cause mortality were 1.30 (1.16-1.44) for one parameter, 1.86 (1.66-2.09) for two parameters and 2.02 (1.75-2.32) for three/four parameters. Consistent results were noted for cardiovascular-, cancer- and other-cause mortality, using other variability indices and in various sensitivity and subgroup analyses. These associations were validated in the HRS (n=1,991). Increased variability in cardiometabolic parameters is associated with elevated risks of all-cause and cause-specific mortality amongst older adults in China. Reducing variability of these parameters could serve as a target to increase life expectancy in older populations.

Blood Pressure Predicted From Artificial Intelligence Analysis of Retinal Images Correlates With Future Cardiovascular Events

BackgroundHigh systolic blood pressure (SBP) is one of the leading modifiable risk factors for premature cardiovascular death. The retinal vasculature exhibits well-documented adaptations to high SBP and these vascular changes are known to correlate with atherosclerotic cardiovascular disease (ASCVD) events. ObjectivesThe purpose of this study was to determine whether using artificial intelligence (AI) to predict an individual’s SBP from retinal images would more accurately correlate with future ASCVD events compared to measured SBP. Methods95,665 macula-centered retinal images drawn from the 51,778 individuals in the UK Biobank who had not experienced an ASCVD event prior to retinal imaging were used. A deep-learning model was trained to predict an individual’s SBP. The correlation of subsequent ASCVD events with the AI-predicted SBP and the mean of the measured SBP acquired at the time of retinal imaging was determined and compared. ResultsThe overall ASCVD event rate observed was 3.4%. The correlation between SBP and future ASCVD events was significantly higher if the AI-predicted SBP was used compared to the measured SBP: 0.067 v 0.049, P = 0.008. Variability in measured SBP in UK Biobank was present (mean absolute difference = 8.2 mm Hg), which impacted the 10-year ASCVD risk score in 6% of the participants. ConclusionsWith the variability and challenges of real-world SBP measurement, AI analysis of retinal images may provide a more reliable and accurate biomarker for predicting future ASCVD events than traditionally measured SBP.

PENGARUH CIRCULO MASSAGE TERHADAP TEKANAN DARAH PADA PENDERITA HIPERTENSI DI DESA SUKOWONO KABUPATEN JEMBER

Circulo Massage is one of massage or massage with the main target of lymph blood circulation. This study aims to determine the effect of circulo massage on blood pressure in hypertensive patients in Sukowono Village, Jember Regency Research using Pre-experimental design with Pretest – Post test Group design. The population of this study were hypertensive patients in Sukowono Village, Jember Regency with a population of 152 respondents divided into 30. The sampling technique used Simple Random Sampling. The intervention process uses a standardized intervention protocol for circulo massage procedures. The results of the study with the Paired Sample T-Test test (α < 0.05) showed a significant effect between the results of giving circulo massage with pre and post intervention systolic blood pressure measurements in hypertensive patients. The results of the study on the measurement of systolic blood pressure before the intervention obtained an average value of 154.67 mmHg and after the intervention obtained an average value of 146 mmHg. The effect of circulo massage on systolic blood pressure with the Paired Sample T-Test statistical test obtained a p value of 0.0001. The conclusion of this study is that there is a significant effect on blood pressure in hypertensive patients before and after being given circulo massage. Researcher recommendations, it is hoped that future researchers will better control other variables outside the study so as to avoid bias in research.

Abstract 4125606: Systolic Blood Pressure During Sleep Determined by Pulse Transit Time Predicts Worsening Heart Failure in Patients with Heart Failure

Introduction: Intensive blood pressure (BP) lowering therapy is associated with lower rates of major adverse cardiac and cerebrovascular events in the general population. On the other hand, lower daytime systolic BP (SBP) is associated with higher mortality in patients with heart failure (HF). However, prognostic impact of SBP during sleep was unclear in patients with HF. Methods and Results: We measured continuous SBP during sleep non-invasively by pulse transit time in 379 patients with HF (median age 71, male 53.6%). Beat-to-beat SBP was calculated based on pulse transit time, which was defined as the travel time from the R-wave of electrocardiogram to the pulse wave at the finger detected by plethysmography. Mean values of SBP during sleep were used in the present study. The primary endpoint was hospitalization for worsening HF. The patients were divided into three groups based on the tertiles of SBP during sleep: High SBP group (median SBP 138 mmHg, n = 127), Middle SBP group (median SBP 117 mmHg, n = 127), and Low SBP group (median SBP 100 mmHg, n = 125). The Low SBP group showed the youngest age (High, Middle, and Low groups; 73, 73, 68 years, P < 0.001). Levels of B-type natriuretic peptide (207.7, 216.7, and 407.2 pg/mL, P = 0.039) and estimated glomerular filtration rate (52.6, 54.0, and 57.1 mL/min/1.73 m 2 , P = 0.041) were the highest in the Low SBP group. During the follow-up period of median 1,083 days after SBP measurement, 66 patients experienced hospitalization for worsening HF. Kaplan-Meier analysis revealed that primary endpoint occurred most frequently in the Low SBP group ( Figure ). Multivariable Cox proportional hazard analysis showed that the lowest SBP tertile was associated with the primary endpoint compared to the highest SBP tertile (hazard ratio 2.546, 95% confidence interval 1.257–5.158, P = 0.009). Conclusion: Low SBP during sleep was associated with hospitalization for HF in patients with HF.

Abstract 4137479: Integrating Ambulatory Care Pharmacists into Value-Based Primary Care: A Scalable Model for Addressing Cardiometabolic Disease

Background: Chronic disease is common, costly, and complicated. In the shift to value-based payment models, interventions to engage patients and improve disease control are necessary to reduce morbidity, mortality, and cost. The use of ambulatory pharmacists has demonstrated improved management of chronic diseases. Traditionally, ambulatory pharmacists are employed by healthcare systems. In this study, we test if integrating ambulatory pharmacists hired, trained, and managed by a retail pharmacy into value-based primary care (VBPC) clinics improves care. Hypothesis: Integrating a Walgreens pharmacist empowered by collaborative drug therapy management agreements (CDTM) into Village Medical (VMD) clinics will improve indicators of chronic disease control. Aims: Improve hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2D) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements in patients with hypertension (HTN). Methods: An ambulatory pharmacist was embedded into VMD clinics in Phoenix, Arizona under the supervision of VMD primary care providers via a CDTM. The pharmacist provided education, coaching, and medication management by prescribing and titrating therapies for treating T2D and HTN - enabled by access to pharmacy dispensing data. β was generated from difference-in-differences (DID) analyses with propensity score matched controls. Results: 125 patients had T2D, and 43 patients had HTN in the intervention group with 250 and 86 in the matched control group, respectively. The mean age was 65 years, 54% were female, 2% non-English speaking, and 29% racial/ethnic minorities. The average baseline HbA1c was 9% in the intervention group and 10% in the matched cohort. The average baseline SBP was 146 mmHg in the intervention group and 142 mmHg in the matched cohort. The β in the T2D group was -1.61% (p<0.001) while the β in the HTN group was -10.2 mmHg (p<0.01) for SBP and -2.0 mmHg (p=0.42) for DBP. Conclusion: We saw significant reductions in SBP and HbA1c in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into VBPC clinics may improve measures of chronic disease known to be associated with morbidity and mortality.

Abstract 4138663: Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study

Background: Clinical implications of high peak nighttime home blood pressure (BP) are currently unknown. This analysis investigated the association between peak nighttime home systolic BP (SBP) and cardiovascular events in individuals with ≥1 cardiovascular risk factor. Methods: In the Japan Morning Surge-Home Blood Pressure (J-HOP) study, nighttime home BP was automatically measured three times every night for 14 days at baseline using a nighttime home BP monitoring device (HEM-5001, Omron Healthcare). Peak nighttime home SBP was defined as average of the highest three values over the 14-night measurement period. Occurrence of cardiovascular events (stroke, coronary artery disease, heart failure, aortic dissection) was determined over a mean 7.1 years’ follow-up. Results: This analysis included 2545 individuals (mean age 63.3±10.3 years, 49% male). After adjustment for covariates (including age, sex, and average office, morning, evening, and nighttime home SBP), stroke risk was significantly higher in individuals with peak nighttime home SBP in the highest (Q5, ≥149.0 mmHg) versus lowest quintile (Q1, <119.3 mmHg) (hazard ratio [HR] 4.24, 95% confidence interval [CI] 1.07–16.77; p=0.039 overall and 8.92, 1.49–53.43; p=0.017 in the subgroup with ≥6 nighttime home SBP measurements). This increased stroke risk remained significant after controlling for day-by-day average real variability of nighttime BP. The average peak nighttime home SBP cut-off value for predicting an increased risk of incident stroke was 136 mmHg. Conclusions: We propose exaggerated peak nighttime home SBP determined from ≥6 measurements as a novel risk factor for stroke, independent of conventional office and home BP values.

Effect of FTO Gene polymorphism on anthropometric, hemodynamic, and autonomic variables in adolescents

Objective: The study aimed to analyze the influence of physical activity levels and the rs9939609 polymorphism (FTO gene) on anthropometric, hemodynamic, and cardiac autonomic variables in public school students. Methods: A total of 288 students (aged 11 to 18, both sexes) from public schools in São Luís, Maranhão, were divided into four groups: sedentary AA+AT (AA+AT sed), active AA+AT (AA+AT activ), sedentary TT (TT sed), and active TT (TT activ). Evaluations included the International Physical Activity Questionnaire, weight, height, body mass index (BMI), buccal cells collection for DNA extraction, systolic (SBP) and diastolic (DBP) blood pressure measurements, and heart rate variability (HRV) analysis. A chi-square test for allelic associations was applied a 5% significance level. Results: No significant differences were observed in DBP or heart rate (HR). The active groups (AA+AT activ and TT activ) exhibited reductions in weight and METs/min/week compared to their respective sedentary groups (P<0.05). The TT activ group also demonstrated reductions in SBP and BMI compared to the TT sed group (P<0.05). The TT activ group had higher HRV in the RR time domain (ms) compared to the TT sed group (P<0.05), though no significant differences were found in other HRV variables. Conclusions: The FTO gene polymorphism influences cardiac autonomic modulation, while physical activity levels affect anthropometric variables.

Oral Toxicity and Hypotensive Influence of Sericin-Derived Oligopeptides (SDOs) from Yellow Silk Cocoons of Bombyx mori in Rodent Studies.

Sericin-derived oligopeptides (SDOs) from yellow silk cocoons exhibit antihypertensive and hypoglycemic properties in both in vitro and in vivo studies. This study investigated the acute toxicity of SDOs as a novel food for human consumption using female ICR mice and Wistar rats, as well as the chronic toxicity test on both sexes of Wistar rats. Clinical chemistry, hematology, and histopathological studies revealed that SDOs were safe for a single dose of 2000 mg kg-1 body weight (BW) and daily oral administration of 50, 100, and 200 mg kg-1 BW for six months. The chronic toxicity study additionally measured the rats' systolic blood pressure (SBP) and blood sugar monthly as they slowly aged. In the 2nd month for male rats and the 4th month for both sexes, SDOs had a significant hypotensive effect on Wistar rats' blood pressure, lowering it from 130 mmHg to a plateau at 110-115 mmHg. In contrast, the blood pressure of the control rats exceeded 140 mmHg after five months. Nonetheless, the hypoglycemic effect was not observed. Measurements of SBP and blood glucose in aged rats during chronic toxicity tests yielded insights beyond ordinary toxicity, including the health and fitness of the lab rats, perhaps resulting in novel discoveries or areas of study that justify the sacrifice of the animals' lives.

Blood pressure and hypertension in older adults with a history of regular cannabis use: findings from the Multi-Ethnic Study of Atherosclerosis.

Observational evidence investigating associations between cannabis use and blood pressure and hypertension is inconsistent. Cross-sectional data from 3,255 participants at Exam 6 (2016-2018) of the Multi-Ethnic Study of Atherosclerosis (MESA) were analyzed, including self-reported cannabis smoking patterns, standardized measures of systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP; BP collectively), and hypertension. ANCOVA and multivariable relative risk regression models were used to calculate adjusted means for BP and adjusted prevalence ratios (PRs) for prevalent hypertension. In fully adjusted ANCOVA models, a history of regular cannabis smoking, when compared to no history, was not significantly associated with increased SBP [mean difference: 0.1 mmHg (95% CI: -1.6-1.9)], DBP [mean difference: 0.5 mmHg (95% CI: -0.3-1.4)], PP [mean difference: -0.5 mmHg (95% CI: -1.8-0.9)], or prevalent hypertension [PR: 1.01 (95% CI: 0.93-1.10)]. Furthermore, no associations were observed for either the duration or recency (in the past month) of cannabis smoking or number of joint/pipe years. Models exploring potential interactions between a history of regular cannabis smoking and age, sex, race/ethnicity, and cigarette smoking status were not significant for either BP or hypertension. In a cohort of racially and ethnically diverse older adults with a high prevalence of hypertension, no evidence of increased risk due to regular cannabis smoking was found for either blood pressure or hypertension.

A flattening systolic blood pressure response at the end of ramp exercise testing is not associated with all-cause mortality

Abstract Purpose Systolic blood pressure (SBP) is expected to rise linearly during ramp exercise, but sometimes plateaus before the end of exercise. We aimed to examine the predictive value of a plateauing SBP response at the end of a cycle exercise test. Methods We analyzed 9,001 consecutive patients aged ≥18 years with maximal cycle ergometer ramp tests, after excluding subjects with valvulopathy, pacemaker, arrhythmia during the test, or body mass index (BMI) >40kg/m², as well as tests with resting SBP <80mmHg or >200mmHg, exercise SBP <100 mmHg, <2 SBP measurements during the second half of the test or a test duration <4 minutes. The data were cross-linked with nationwide registries for mortality and in- and outpatient hospital diagnoses. The difference in SBP between the two last SBP measurements was standardized to the difference in Watts between the same time points, categorized as i) an SBP decrease (drop), ii) an SBP increase of <2.5 mmHg per 10 Watts increase (flat), iii) an SBP increase of 2.5-15 mmHg/10 Watts (intermediate), and iv) an SBP increase >15 mmHg/10 Watts representing the 97.5th percentile (steep). Hazards ratios (HR, [95% confidence interval, CI]) for all-cause mortality were calculated, stratified for exercise capacity (peak Watt % of predicted) with the intermediate SBP response as reference. Adjustments were made for age, sex, BMI, resting SBP, baseline diagnosis of ischemic heart disease, heart failure, chronic obstructive pulmonary disease, and the use of beta-blockers or anti-hypertensive medication. Results Decreasing, flat, intermediate, and steep SBP responses at the end of exercise were present in 1.1%, 25.6%, 70.8% and 2.5% of patients respectively (Table 1). During median follow-up 8.6 years (interquartile range 5.9–11.6 years) there were 844 deaths. When compared to an intermediate SBP response, a flat SBP response was not associated with all-cause mortality in any of the exercise capacity strata: lowest tertile of Wmax%pred unadjusted HR 0.88 (95% CI 0.69–1.11), middle tertile HR 0.91 (95% CI 0.66–1.24), and highest tertile HR 0.95 (95% CI 0.64–1.41), with HRs remaining non-significant after adjustment for covariates (Table 2). Conclusion In patients referred for exercise testing, a flattening SBP response at the end of exercise was not associated with increased all-cause mortality risk compared to an intermediate SBP response, consistent across the different exercise capacity strata.

The added value of device measured physical activity to the prediction of incident cardiovascular disease.

Abstract Background Conventional risk prediction models for Major Adverse Cardio/Cerebrovascular Events (MACCE) primarily rely on non-modifiable factors such as age, sex, and physiological measurements, including LDL/HDL cholesterol and blood pressure readings, that are prone to variations across medical practices and are often unavailable in many parts of the world. In this study, we investigate the potential of inexpensive wearable measurements of physical activity to enhance MACCE prediction when physiological measurements are unavailable. Purpose To assess the added value of physical activity measurements, collected via wrist-worn accelerometers, to established cardiovascular risk prediction models. Additionally, we seek to investigate whether physical activity measurements can substitute for common physiological measurements in established cardiovascular risk models. Methods We obtained accelerometer-measured physical activity over 7 days between 2013 and 2015 from 69,898 UK Biobank (UKB) participants without a prior history of MACCE, defined as death or hospitalisation due to (1) myocardial infarction, (2) heart failure, or (3) Stroke/transient ischaemic attack. We assessed the added value of daily step counts, sleep duration, and a deep learning-derived activity health score (Fig 1), calculated from complete 7-day accelerometer recordings, to established clinical risk models (SCORE2, QRISK3 and AHA) before and after excluding measurements of cholesterol and systolic blood pressure (SBP). The primary outcome was the first recorded MACCE within 6 years. Risk scores were developed in men and women using Cox proportional hazards models. We assessed predictive performance using Harrel’s C-index, net reclassification index (NRI), and net benefit at the recommended treatment threshold for each model. Results Of the 69,898 UKB participants in the study, 3,386 (4.8%) experienced a MACCE over a 6-year follow-up period. In place of HDL ratio and SBP, the addition of deep-learned activity health scores modestly improved performance in the best clinical baseline, QRISK3 for Female participants ΔC-index women:0.003 (95% CI 0.002-0.004); Δnet benefit 0.02(0.01-0.03); NRI 0.04, (0.02-0.07), and outperformed manually extracted steps and sleep measurements. We report no significant improvements for men. We find a greater increase in model performance when both HDL ratio and SBP, plus activity health scores, are included in the model. ΔC-index women:0.008, (0.007-0.009); men: 0.003 (0.002-0.004) (Fig 2). Conclusion Our findings indicate that in the absence of cholesterol and systolic blood pressure, the addition of device-measured physical activity modestly improves the performance of clinical risk scores among individuals without prior cardiovascular disease (CVD). These findings could further refine intervention strategies for targeted prevention of CVD, particularly in settings where physiological measurements may be unavailable.

Genome-wide association study of CMR image-based aortic stiffness in 45,789 individuals identifies loci linked with cardiovascular diseases

Abstract Background The use of artificial intelligence on large-scale cardiac magnetic resonance (CMR) imaging data has enabled detailed characterisation of cardiac shape and function for use in genome-wide association studies (GWAS), leading to improved understanding of genetic aetiology of cardiovascular diseases (CVDs). Aortic stiffness is associated with increased risk of cardiovascular events in observational studies. Here, we present a novel CMR-based pressure-independent measure of aortic stiffness, identify genetic associations and explore links with CVDs. Purpose Identify genetic contributions to pressure-independent aortic stiffness and links to CVDs using large-scale GWAS analysis on the UK Biobank cohort. Methods A pre-trained neural network was used to segment CMR images of participants in the UK Biobank to quantify ascending aorta diameter, which together with contemporaneous systolic and diastolic blood pressure measurements (SBP, DBP, respectively) were used to calculate a pressure-independent measure of aortic stiffness (β0). The measurement assumes an exponential relationship between pressure and aortic diameter. We then performed a GWAS on β0 in 45,789 participants of European ancestry without CVDs. A multi-trait-based conditional & joint analysis (mtCOJO) was performed to estimate genetic effects independent of SBP, DBP and aortic area. We mapped the independent lead variants associated with aortic stiffness at P < 5x10-8 to nearest gene, and characterised shared genetic association across CVDs using Open Targets Platform database. Results The GWAS identified 17 independent lead variants, including 6 that remained significant in the conditional analysis. Four of these lead variants, not previously reported in GWAS of other aortic traits, were located near CTD-2203A3.1, MCF2L, CFDP1 and CDH13 genes (red annotations in the Figure). MCF2L, CFDP1 and CDH13 have been associated with coronary artery disease, and CFDP1 with myocardial infarction and coronary atherosclerosis in previous studies. Conclusion A GWAS of CMR-derived aortic stiffness identified 4 loci distinct from other aortic traits that also associate with other CVDs, suggesting genetic links between aortic stiffness and CVDs. Further analyses are required to explore biological mechanisms underlying these genetic associations.Aortic Stiffness Manhattan Plot

Orthostatic blood pressure changes and incident atrial fibrillation in patients with hypertension: Insights from the SPRINT trial

Abstract Background Exaggerated orthostatic changes in systolic blood pressure (SBP) were associated with adverse cardiovascular events. However, the predictive role of SBP hyperactivity to standing on incident atrial fibrillation (AF) is unclear. Purpose We aim to assess the association between orthostatic SBP changes and incident AF. Methods We performed a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a randomized controlled trial comparing intensive (<120 mm Hg) and standard (<140 mm Hg) SBP interventions in participants with hypertension. Participants with standing SBP <110 mm Hg were not eligible for randomization according to the SPRINT protocol. Participants without AF who had seated and standing SBP measurements at baseline and available baseline or follow-up ECG were included in this analysis. Orthostatic SBP changes were defined as standing SBP minus seated SBP. Patients were grouped into tertiles of orthostatic SBP changes. AF was ascertained from the standard 12-lead ECG obtained at baseline, year 2, year 4, a close-out visit, and any visit when suspected of serious adverse events. We used Cox proportional regression models and restricted spline curves to assess the association of orthostatic SBP changes with incident AF. Results Among 8,455 participants included in this analysis, 327 incident AF cases occurred during follow-up. The restricted spline curve depicted a U-shaped relationship between orthostatic SBP changes and incident AF in the unadjusted model (P for nonlinearity = 0.012) (Figure 1). After adjusting for age, female, race, smoking, alcohol use, history of cardiovascular disease, history of chronic kidney disease, and body mass index, a SBP increase ≥ 6 mm Hg to standing was independently associated with a 43% higher risk of incident AF (HR: 1.43; 95% CI: 1.07-1.90; P = 0.014) compared to nonsignificant orthostatic SBP changes (>-4 mm Hg to <6 mm Hg). A SBP decrease ≥ 4 mm Hg to standing showed a nonsignificant higher risk of developing AF compared to SBP changes of >-4 mm Hg to <6 mm Hg (Figure 2). In subgroup analysis, the results presented a similar tendency to the main result. Sensitivity analyses also generated consistent results while additionally adjusting for seated and standing blood pressure or heart rate. Conclusion In this post hoc analysis of the SPRINT trial, exaggerated SBP increase to standing independently predicts incident AF.Figure 1Figure 2

Cardio-Metabolic Risk Profile of Women With Endometriosis: A Population-Based Study.

Endometriosis (EM) and metabolic disorders are frequent health problems among reproductive-aged women worldwide. Cardio-metabolic risk profile of women with EM is not well understood. We aimed to investigate the cardio-metabolic risk profile of Iranian reproductive-aged women with EM. This study included 976 female participants aged 20-45 years of Tehran Lipid and Glucose Study. Endometriosis was diagnosed based on the participants' self-reported previous diagnosis of EM, which was confirmed by reviewing the relevant medical documentation. All biochemical measures (low-density lipoprotein cholesterol [LDL], high-density lipoprotein cholesterol [HDL], triglycerides [TG], and fasting blood glucose concentrations [FBG]) and measurement of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and anthropometric parameters were performed according to the standard protocol of TLGS. Logistic regression analysis was performed to estimate the odds ratio of cardio-metabolic disease. Of the 976 study participants, 161 individuals (16.5%) had a confirmed diagnosis of endometriosis. There were no significant differences in the median of metabolic parameters among women with and without endometriosis (p > 0.05). The prevalence of metabolic syndrome was significantly higher in women with EM group compared to the non-EM group (21.9% vs. 14.9%). The presence of endometriosis was associated with an increased odds of metabolic syndrome (adjusted odds ratio 1.99 [95% CI 1.20-3.30]; p = 0.007). And endometriosis significantly increased odds of low HDL by 2.07 (1.02-4.20); after adjustment, it still remained significant (p = 0.03). Endometriosis also increased odds of high waist circumstance significantly (1.58 [1.06-2.37]; p = 0.02). Women with endometriosis may be at an increased risk of developing metabolic syndrome, high waist circumstance and low HDL compared to their counterparts without the condition. Given the potential cardio-metabolic implications, healthcare providers should consider assessing the metabolic profile of women diagnosed with endometriosis.

Non-invasive blood pressure measurement in conscious rabbits: A comparison of Doppler ultrasonic and oscillometric devices.

This study aimed to compare Doppler (the most commonly used technique for non-invasive indirect blood pressure [NIBP] measurement in rabbits) and oscillometric devices for NIBP measurements in conscious rabbits. Blood pressure (BP) measurements were obtained for49 conscious rabbits using the Doppler and oscillometric devices. Each measurement was repeated in triplicate. Three rabbits were excluded from the study because it was not possible to obtain BP measurements using the oscillometric device. The American College of Veterinary Internal Medicine (ACVIM) guidelines were followed to compare the results obtained with the two devices. A total of 164 systolic BP measurements were obtained with the Doppler device and 182 were obtained with the oscillometric technique. The mean of the three values obtained for each animal with each device was used for statistical analysis. The analysis demonstrated a poor level of agreement between the measurements obtained with the two devices. Oscillometric devices rely on built-in software algorithms to perform calculations and produce their measurements. However, the oscillometric devices currently available only have the software for dogs and cats installed. Therefore, these conclusions should be revised when a device with software specifically for rabbits is commercialised. This study indicates that oscillometric devices should not be used as a substitute for the Doppler technique when measuring BP in rabbits.

The EAT-Lancet diet associated cardiovascular health parameters: evidence from a Brazilian study

BackgroundThe EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil.MethodsThis is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from “Brazilian Usual Consumption Assessment” study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little’s MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet’s sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson’s chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters.ResultsThe mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: “packaged snacks, shoestring potatoes, and crackers” (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C.ConclusionsThe results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.

WITHDRAWN: Non-Contact Blood Pressure Monitoring from Radar Signals by a Temporal-Spatial Feature Fusion Network

Non-contact blood pressure (BP) monitoring offers a comfortable and uninterrupted means of BP assessment, free from the constraints of physical contact. This capability is particularly better for the routine surveillance of BP for individuals with hypertension, burn injuries, skin sensitivities, and other pertinent conditions. In this study, we proposed a Temporal-Spatial Feature Fusion Network (TSFN), a radar-based, non-contact approach for BP monitoring. The TSFN architecture combines Residual Networks (ResNet) for the meticulous extraction of spatial features from radar signals, Gated Recurrent Unit (GRU) for the discernment of temporal dynamics, and Multiple Head Attention (MHA) to selectively emphasize crucial information. These components collectively ensure precise BP detection from radar signals. To enhance the model's robustness, a Pseudo-Huber loss function was employed to refine the optimization process, providing a smoother gradient transition and improved stability. Evaluations demonstrated impressive accuracies, with mean errors of 0.24±6.78 mmHg for systolic blood pressure (SBP) and 0.25±5.13 mmHg for diastolic blood pressure (DBP). These outcomes meet the standards set by the British Hypertension Society (BHS) for grade ‘A’ benchmarks for SBP and DBP measurements. Notably, the TSFN model avoids the need for complex feature engineering, demonstrating its effectiveness in monitoring BP fluctuations across diverse physiological states at 2s intervals. This feature highlights its potential applicability in real-time monitoring systems, offering a promising solution for continuous, non-contact BP monitoring.

Survival status and its predictors among adult victims of road traffic accident admitted to public hospitals of Bahir Bar City, Amhara regional state, Northwest, Ethiopia, 2023: multi center retrospective follow-up study

IntroductionRoad traffic accident is the most common cause of death in adults worldwide. Road traffic accident-related deaths increased from time to time in low- and middle-income countries including Ethiopia; however, there is limited evidence about Survival status and its predictors among adult victims of road traffic accidents admitted to Hospitals in Ethiopia specifically in the study area. Thus, this study aimed to assess Survival status and its predictors among adult victims of road traffic accident admitted to Hospitals.MethodsAn institutional-based retrospective follow-up study was conducted from July 01/2019 to June 30/2022. A total of 402 samples were chosen using simple random sampling. Data was collected by a prepared checklist from the victims’ chart and entered into Epi-Data version 4.6 software and then exported to STATA version 14.1 for analysis. Kaplan-Meier failure function and log-rank test were computed. The assumption was checked by Schoenfeld residual test. All variables in bivariable analysis, p-value < 0.25 were entered into multivariable cox-regression model. Adjusted Hazard Ratio with 95% Confidence Interval was reported to declare the strength of association and statistical significance p-value of < 0.05. Model fitness was checked by using Cox-Snell residual. Data was presented by text, table, and graph.ResultThe median survival time was 504 h. From all, 63(15.6%) deaths, 57% of deaths occurred between 24 and 168 h of follow-up with an overall incidence of 15.34deaths per10, 000 victims-hours observation. According to the Kaplan-Meier failure curve together with the log-rank test, the incidence density rate of death among victims who had a complication during admission was71.86per10,000victims-hour observation (95%, CI:53.66–96.25), which is different from those who did not have complication 5.17per10,000person-hour observation (95%, CI:3.26–8.21). The incidence density rate of death among victims who had low level of arterial oxygen saturation (SPO2 < 95%) during admission was 82.87per10, 000 victims-hour observation (95%, CI: 63.15-108.75), which is different from those who had arterial oxygen saturation ≥ 95% 3.16per10, 000victims -hour observation (95%, CI: 1.75–5.71) Develop complication (AHR = 3.1,95% CI:1.44–6.70), systolic blood pressure measurement value ≤ 89 mmHg (AHR = 2.4,95% CI:1.10–5.19), not admitted intensive care unit (AHR = 0.46,95% CI:0.022–0.97), Glasgow Coma Scale score ≤ 8 (AHR = 2.9,95% CI:1.07–7.75), Glasgow Coma Scale score 9–12(AHR = 3.8,95% CI:1.61–8.97) and, level of arterial oxygen saturation ≤ 95% (AHR = 6.5,95% CI:2.38–17.64) were predictors of outcome variable.Conclusion and recommendationsThe median survival time was short. Complication, low systolic blood pressure measurement value, low Glasgow Coma Scale score, not admit to intensive care unit and low level of arterial oxygen saturation were significant predictors of the outcome variable. So that healthcare providers better give special attention and care to those victims admitted to Hospitals. A further prospective study is recommended.

Fiber Bragg Grating Pulse and Systolic Blood Pressure Measurement System Based on Mach-Zehnder Interferometer.

A fiber Bragg grating (FBG) pulse and systolic blood pressure (SBP) measurement system based on the edge-filtering method is proposed. The edge filter is the Mach-Zehnder interferometer (MZI) fabricated by two fiber couplers with a linear slope of 52.45 dBm/nm. The developed system consists of a broadband light source, an edge filter, fiber Bragg gratings (FBGs), a coarse wavelength-division multiplexer (CWDM), and signal-processing circuits based on a field-programmable gate array (FPGA). It can simultaneously measure pulse pulsations of the radial artery in the wrist at three positions: Cun, Guan and Chi. The SBP can be calculated based on the pulse transit time (PTT) principle. The measurement results compared to a standard blood pressure monitor showed the mean absolute error (MAE) and standard deviation (STD) of the SBP were 0.93 ± 3.13 mmHg. The system meets the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) equipment standards. The proposed system can achieve continuous real-time measurement of pulse and SBP and has the advantages of fast detection speed, stable performance, and no compression sensation for subjects. The system has important application value in the fields of human health monitoring and medical device development.