Systolic Blood Pressure Values Research Articles

Disease severity and renal function among sickle cell anaemia patients in a tertiary hospital, South-south, Nigeria: a cross sectional study.

Renal disease is a recognized complication of sickle cell anaemia (SCA), especially from the third decade of life and is linked to disease severity. This study assessed the association between disease severity and renal function among SCA patients using routine and newer markers of renal function. This cross-sectional study recruited 85 SCA patients. Disease severity was assessed using modified Adegoke criteria which include the frequency of transfusion, painful crises, packed cell volume, and history of complications such as hypertension and chronic leg ulcers. Renal function was assessed using urea, creatinine, and beta-2-microglobulin (β2-M). Association was determined between renal function and disease severity using Pearson's correlation. P-value < 0.05 was taken as significant. The mean age of participants was 27.2 ± 7.6 years with 41(48.2%) males and 44 (51.8%) females. The mean packed cell volume, serum creatinine, serum urea, and β2-M were 24.0± 4.1%,17.6±7.5 mg/dL, 0.7±0.3mg/dL, 3.4±1.2mg/l respectively. A majority (54.1%) of them had a mild disease while 35.3% and 10.6% had moderate and severe diseases, respectively. Forty of the SCA patients had urine specific gravity below 1.010. The mean values of systolic blood pressure (p=0.001) diastolic blood pressure (p=0.001), serum creatinine (p=0.028) and β2M (p=0.019) significantly increased with disease severity. There was a significant positive correlation between SCA disease severity and serum urea (r=0.229; p=0.035), and serum β2-microglobulin (r=0.270; p=0.012). Sickle cell anaemia severity is associated with a decline in renal function using both traditional and novel renal markers. Serum β2-M may serve as a useful marker of renal function and disease severity in SCA.

Pengaruh Konsumsi Rebusan Daun Pandan terhadap Tekanan Darah Wanita Lansia Penderita Hipertensi di Nusalaut Maluku Tengah

Hypertension is a condition where a person experiences an increase in blood pressure above normal where the systolic pressure is 140 mmHg and the diastolic pressure is 90 mmHg, so that it can lead to pain, complications and death. As the age of elderly women increases, the risk of developing hypertension becomes greater and will cause problems if not addressed or prevented. Hypertension control can be done by pharmacological and non-pharmacological treatment with the application of herbal plants, that is Pandanus amaryllifolius leaf decoction. This study aims to determine the effect of consumption of pandan leaf decoction on the blood pressure of elderly women with hypertension in the work area of Ameth Public Health Nusalaut Central Maluku. The research design used was a quasi-experimental design with a pre and post test design with a control group. The research sample amounted to 34 respondents consisting of 17 people in the experimental group and 17 people in the control group. The sampling technique used purposive sampling. Data analysis used Wilcoxon test and Man Whitney test. The results of the Wilcoxon test showed that the systolic and diastolic blood pressure of the experimental group had p value &lt; 0.05, while the control group's systolic blood pressure was p value &lt; 0.05 and diastolic blood pressure was &gt; 0.05. diastolic pressure, but not significant to the control group diastolic pressure. The results of the Man Whitney test showed that the systolic blood pressure value was p &lt; 0.05 and the diastolic p value was &gt; 0.05. This shows that there are significant differences in the decrease in systolic blood pressure, but not significant differences in diastolic pressure. Consumption of pandan leaf decoction affects the blood pressure of women with hypertension. Pandanus amaryllifolius leaf decoction can be applied in non-pharmacological treatment as a companion for hypertension treatment in health care institutions

Office blood pressure variability in non-hypertensive patients during a preventive examination

Background: Despite advantages of ambulatory and home blood pressure monitoring, office blood pressure measurement remains the principal method for the diagnosis and management of hypertension. There still seems to be too little evidence to date showing variation in blood pressure during a medical visit and the current recommendations are mainly based on expert’s opinions. The aim of this study was to evaluate the difference between the first two blood pressure measurements performed during a preventive examination and to verify whether the second measurement could influence clinical decisions in non-hypertensive patients. Material and methods: The study included 52 consecutive patients without history of hypertension or other cardiovascular diseases. Blood pressure and heart rate (HR) were measured twice, the first reading after 5 minutes rest and the second 1 minute later. Results: Significant differences were found between the first (fBPM) and second (sBPM) blood pressure measurements, both systolic blood pressure (SBP) 142.4 mm Hg [interquartile range (IQR): 130.8–152.0] vs. 138.1 mm Hg (IQR: 125.8–149.5), p &lt; 0.001 and diastolic blood pressure (DBP) 85.8 mm Hg (IQR: 80.0–91.5) vs. 83.9 mm Hg (IQR: 77.0–90.3), p &lt; 0.001, and heart rate (HR) 73.1/min (IQR: 64.8–80.0) vs. 71.8/min (IQR: 64.8–77.3), p &lt; 0.001. In 63.5% of the participants, the difference between the measurements was over 5 mm Hg for SBP values and in 23.1% of the participants for DBP values. According to fBPM, 53.8% of the patients met the criteria for the diagnosis of hypertension and according to sBPM 48.1% (NS). Conclusion: We demonstrated substantial discrepancies between blood pressure values taken during the first and the second preventive medical check-up visit performed in the workplace. Preventive examination in the workspace is associated with similar number of false-positive results when hypertension status is evaluated as compared to regular office visits.

Deep phenotype characterization of hypertensive response to exercise: implications on functional capacity and prognosis across the heart failure spectrum

Limited evidence is available regarding the role of hypertensive response to exercise (HRE) in heart failure (HF). We evaluated the systolic blood pressure (SBP) to workload slope during exercise across the HF spectrum, investigating haemodynamic and prognostic correlates of HRE. We prospectively enrolled 369 patients with HF Stage C (143 had preserved [HFpEF], and 226 reduced [HFrEF] ejection fraction), 201 subjects at risk of developing HF (HF Stages A-B), and 58 healthy controls. We performed a combined cardiopulmonary exercise stress echocardiography testing. We defined HRE as the highest sex-specific SBP/workload slope tertile in each HF stage. Median SBP/workload slope was 0.53 mmHg/W (interquartile range 0.36-0.72); the slope was 39% steeper in women than men (p < 0.0001). After adjusting for age and sex, SBP/workload slope in HFrEF (0.47, 0.30-0.63) was similar to controls (0.43, 0.35-0.57) but significantly lower than Stages A-B (0.61, 0.47-0.75) and HFpEF (0.63, 0.42-0.86). Patients with HRE showed significantly lower peak oxygen consumption and peripheral oxygen extraction. After a median follow-up of 16 months, HRE was independently associated with adverse outcomes (all-cause mortality and hospitalization for cardiovascular reasons: hazard ratio 2.05, 95% confidence interval 1.81-5.18), while rest and peak SBP were not. Kaplan-Meier analysis confirmed a worse survival probability in Stages A-B (p=0.005) and HFpEF (p < 0.001), but not HFrEF. A steeper SBP/workload slope is associated with impaired functional capacity across the HF spectrum and could be a more sensitive predictor of adverse events than absolute SBP values, mainly in patients in Stages A-B and HFpEF.

A Novel Cuffless Blood Pressure Prediction: Uncovering New Features and New Hybrid ML Models.

This paper investigates new feature extraction and regression methods for predicting cuffless blood pressure from PPG signals. Cuffless blood pressure is a technology that measures blood pressure without needing a cuff. This technology can be used in various medical applications, including home health monitoring, clinical uses, and portable devices. The new feature extraction method involves extracting meaningful features (time and chaotic features) from the PPG signals in the prediction of systolic blood pressure (SBP) and diastolic blood pressure (DBP) values. These extracted features are then used as inputs to regression models, which are used to predict cuffless blood pressure. The regression model performances were evaluated using root mean squared error (RMSE), R2, mean square error (MSE), and the mean absolute error (MAE). The obtained RMSE was 4.277 for systolic blood pressure (SBP) values using the Matérn 5/2 Gaussian process regression model. The obtained RMSE was 2.303 for diastolic blood pressure (DBP) values using the rational quadratic Gaussian process regression model. The results of this study have shown that the proposed feature extraction and regression models can predict cuffless blood pressure with reasonable accuracy. This study provides a novel approach for predicting cuffless blood pressure and can be used to develop more accurate models in the future.

Systolic blood pressure reduction with tirzepatide in patients with type 2 diabetes: insights from SURPASS clinical program

BackgroundTirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide/ glucagon-like peptide-1 receptor agonist, is approved in the United States, Europe and Japan for the treatment of type 2 diabetes. Across the SURPASS-1 to -5 clinical studies, tirzepatide 5, 10 and 15 mg demonstrated significant improvements in glycated haemoglobin A1c (HbA1c) (− 1.9 to − 2.6%), body weight (− 6.6 to − 13.9%) and systolic blood pressure (SBP) (− 2.8 to − 12.6 mmHg) at the end of study treatment.MethodsPost-hoc mediation analyses were conducted to evaluate weight-loss dependent and weight-loss independent effects of tirzepatide on SBP reductions across the 5 SURPASS studies. The safety population (all randomized patients who took at least 1 dose of study drug) of each study was analyzed. Additional analyses were conducted at individual study level or pooled across 5 SURPASS trials.ResultsThe difference in mean SBP change from baseline at 40 weeks (total effect) between the tirzepatide and comparator groups was − 1.3 to − 5.1 mmHg (tirzepatide 5 mg), − 1.7 to − 6.5 mmHg (tirzepatide 10 mg) and − 3.1 to − 11.5 mmHg (tirzepatide 15 mg). These SBP reductions were primarily mediated through weight loss, with different degrees of contributions from weight-loss independent effects across the different trials. In the SURPASS-4 study, which enrolled patients with established cardiovascular disease, weight-loss independent effects explained 33% to 57% of difference in SBP change between tirzepatide and insulin glargine groups. In a pooled analysis of the SURPASS-1 to -5 studies, there was a significant (p < 0.001) but weak correlation (r = 0.18 to 0.22) between change in body weight and SBP. Reductions in SBP with tirzepatide were not dependent on concomitant antihypertensive medications at baseline as similar reductions were observed whether participants were receiving them or not (interaction p = 0.77). The largest SBP reductions were observed in the highest baseline category (> 140 mmHg), while those in the first quartile of baseline SBP category (< 122 mmHg) observed no further decrease in SBP.ConclusionsTirzepatide-induced SBP reduction was primarily mediated through weight loss, with different degrees of contributions from weight-loss independent effects across the different trials. SBP reduction was not dependent on antihypertensive medication use but dependent on baseline SBP value, alleviating theoretical concerns of hypotension.

Perineal nerve block versus periprostatic block for patients undergoing transperineal prostate biopsy (APROPOS): a prospective, multicentre, randomised controlled study

We aimed to investigate perineal nerve block versus periprostatic block in pain control for men undergoing a transperineal prostate biopsy. In this prospective, randomised, blinded and parallel-group trial, men in six Chinese hospitals with suspected prostate cancer were randomly assigned (1:1) at the point of local anaesthesia to receive a perineal nerve block or periprostatic block and followed by a transperineal prostate biopsy. Centres used their usual biopsy procedure. Operators who performed anaesthesia were trained in both techniques before the trial and were masked to the randomised allocation until the time of anaesthesia and were not involved in the subsequent biopsy procedure and any assessment or analysis. Other investigators and the patients were masked until trial completion. The primary outcome was the level of the worst pain experienced during the prostate biopsy procedure. Secondary outcomes included pain (post-biopsy at 1, 6 and 24h), changes in blood pressure, heart rate and breathing rate during the biopsy procedure, external manifestations of pain during biopsy, anaesthesia satisfaction, the detection rate of PCa and clinically significant PCa. This trial is registered on ClinicalTrials.gov, NCT04501055. Between August 13, 2020, and July 20, 2022, 192 men were randomly assigned to perineal nerve block or periprostatic block, 96 per study group. Perineal nerve block was superior for the relief of pain during the biopsy procedure (mean 2.80 for perineal nerve block and 3.98 for periprostatic block; adjusted difference in means-1.17, P<0.001). Although the perineal nerve block had a lower mean pain score at 1h post-biopsy compared with the periprostatic block (0.23 vs 0.43, P=0.042), they were equivalent at 6h (0.16 vs 0.25, P=0.389) and 24h (0.10 vs 0.26, P=0.184) respectively. For the change in vital signs during biopsy procedure, perineal nerve block was significantly superior to periprostatic block in terms of maximum value of systolic blood pressure, maximum value of mean arterial pressure and maximum value of heart rate. There are no statistical differences in average value of systolic blood pressure, average value of mean, average value of heart rate, diastolic blood pressure and breathing rate. Perineal nerve block was also superior to periprostatic block in external manifestations of pain (1.88 vs 3.00, P<0.001) and anaesthesia satisfaction (8.93 vs 11.90, P<0.001). Equivalence was shown for the detection rate of PCa (31.25% for perineal nerve block and 29.17% for periprostatic block, P=0.753) or csPCa (23.96% for perineal nerve block and 20.83% for periprostatic block, P=0.604). 33 (34.8%) of 96 patients in the perineal nerve block group and 40 (41.67%) of 96 patients in the periprostatic block group had at least one complication. Perineal nerve block was superior to periprostatic block in pain control for men undergoing a transperineal prostate biopsy. Grant 2019YFC0119100 from the National Key Research and Development Program of China.

Prediction of cardiovascular disease risk based on major contributing features

The risk of cardiovascular disease (CVD) is a serious health threat to human society worldwide. The use of machine learning methods to predict the risk of CVD is of great relevance to identify high-risk patients and take timely interventions. In this study, we propose the XGBH machine learning model, which is a CVD risk prediction model based on key contributing features. In this paper, the generalisation of the model was enhanced by adding retrospective data of 14,832 Chinese Shanxi CVD patients to the kaggle dataset. The XGBH risk prediction model proposed in this paper was validated to be highly accurate (AUC = 0.81) compared to the baseline risk score (AUC = 0.65), and the accuracy of the model for CVD risk prediction was improved with the inclusion of the conventional biometric BMI variable. To increase the clinical application of the model, a simpler diagnostic model was designed in this paper, which requires only three characteristics from the patient (age, value of systolic blood pressure and whether cholesterol is normal or not) to enable early intervention in the treatment of high-risk patients with a slight reduction in accuracy (AUC = 0.79). Ultimately, a CVD risk score model with few features and high accuracy will be established based on the main contributing features. Of course, further prospective studies, as well as studies with other populations, are needed to assess the actual clinical effectiveness of the XGBH risk prediction model.

Does Practitioner Experience Affect Intraocular Pressure After Endotracheal Intubation?

Intraocular pressure (IOP) may decrease or increase during general anesthesia, depending on various factors. This study aimed to investigate theeffects of the level of provider training period on post-intubation IOP values and hemodynamic response. This study was a cross-sectional observational study. Before inclusion in the study, informed consent was obtained from all participants. The study was approved by the localethical committee. The study included 120 adult patients, both sexes, aged between 18 and 65, with physical statuses according to the American Society of Anesthesiologists (ASA) I or II, Mallampati score I. The research included 120 anesthesiologist resident doctors who received their training in our clinic. In this study, anesthesiology resident doctors were divided into three separate seniority groups (group 1, less than one-year residents in anesthesiology who had performed fewer than 10 intubations; group 2, one- to three-year residents; and group 3, more than three-year residents). After receiving a standard intravenous induction, direct laryngoscopy and endotracheal intubation techniques were performed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and IOP were measured and recorded before pre-induction (T1), the first minute after induction (T2), and the first minute after laryngoscopy and intubation (T3). There was nostatistically significant difference (p > 0.05) between groups in the values of IOP, SBP, DBP, and HR measured at T1, T2, and T3. Measurements at T1, T2, and T3 were similar in all three groups. Comparisons within the groups revealed that IOP values at all measurement times (T1, T2, and T3)were different from each other in less than three-year resident groups. This difference was statistically significant (p < 0.001). The measurement values at T2 were the lowest and T3 were the highest in less than three-year resident groups. There was a significant increase in IOP after endotracheal intubation (T3) compared to baseline levels (T1) in less than three-year resident groups. IOP values at T2 were also significantly lower than the values at T1 and T3(p < 0.001) in the more than three-year resident group (group 3). However, when we compared IOP measurements at T1 and T3 among themselves in the more than three-year resident group, no significant difference was found (p > 0.05). This study showed that endotracheal intubation in general anesthesia practice is performed most effectively by resident doctors with more than three years of anesthesiology training, without changing the IOP value.

Polymorphic Variant rs11206510 in PCSK9 and Risk of Coronary Artery Disease in Bulgarians

Abstract Objective The aim of this study was to investigate the potential association of rs11206510 in PCSK9 gene with coronary artery disease (CAD) and myocardial infarction (MI) in Bulgarians. Materials and Methods The current analysis included 261 patients with angiographically documented CAD (153 with MI and 108 without MI) and 496 population – based controls. Genomic DNA was extracted from venous blood samples. The selected polymorphism was genotyped by TaqMan SNP Genotyping Assay. The genotype and allele frequencies were compared between cases and controls using χ2 test. Results In this study, the presence of the T allele of rs11206510 in the PCSK9 gene was found to be associated with elevated risk for MI in patients with already existing myocardial ischemia (allele T, OR1.78,CI95:1.16-2.73, p = 0.007). The result was enhanced in the male subgroup (allele T, OR1.74, CI95:1.02-2.96, p = 0.038). Also, we found reduced risk of CAD (without MI) for T allele (OR0.70, CI95:0.49-0.99, p = 0.04). This trend was stronger in the male subgroup (OR0.56, CI95:0.35-0.90, p = 0.02). There was not any relationship of the studied genetic variant with the levels of total cholesterol, triglycerides, low density lipoproteins and high-density lipoproteins, or with systolic and diastolic blood pressure values. Conclusion Our study found a difference in the frequencies of rs11206510 genotypes and alleles in the PCSK9 gene between cases and controls, and the relationship of the investigated polymorphism to the risk of cardiac injury in the Bulgarian population was demonstrated. Further investigations with a larger number of cases and controls will be needed in order to evaluate a possible association between this variant and CAD/MI in Bulgarians.

The Effect of Health Literacy on Patient Outcomes in Stage 3b-4 Pre-Dialysis Patients: A Semi-Experimental Study

ABSTRACT This study was conducted to investigate the effect of health literacy on patient outcomes in pre-dialysis patients. A semi-experimental study. The study was conducted with 45 intervention and 45 control patients with glomerular filtration rates between 15–44ml/min/1.73m2. The adequate health literacy of the patients in the intervention group increased from 2.2% to 31.1%. Increased health literacy led to a significant decrease in systolic and diastolic blood pressure values and the severity of symptoms. The study showed that increased health literacy in pre-dialysis patients improves patient outcomes. Nursing care is needed in pre-dialysis.

Age- and sex-stratified normal values for circulatory and ventilatory power during ramp exercise derived from a healthy Japanese population.

Circulatory power (CP) and ventilatory power (VP), obtained by cardiopulmonary exercise testing (CPX), have been suggested to be excellent prognostic markers for heart failure. However, the normal values of these parameters in healthy Japanese populations remain unknown; thus, we aimed to investigate these values in such a population. A total of 391 healthy Japanese participants, 20-78years of age, underwent CPX with a cycle ergometer with ramp protocols. Systolic blood pressure (SBP), heart rate, oxygen uptake ([Formula: see text]O2) at peak exercise, and the slope of minute ventilation ([Formula: see text]E) versus carbon dioxide ([Formula: see text]CO2) ([Formula: see text]E vs. [Formula: see text]CO2 slope) were measured. CP was calculated by multiplying the peak [Formula: see text]O2 and SBP values, and VP was calculated by dividing the peak SBP value by the [Formula: see text]E versus [Formula: see text]CO2 slope. For males and females, the average CP values were 6119 ± 1280 (mean ± standard deviation) and 4775 ± 914mmHg·mL/min/kg, respectively (p < 0.001). The average VP values for males and females were 8.0 ± 1.3 and 6.9 ± 1.3mmHg (p < 0.001). CP decreased with age in both sexes. VP increased with age in females, with no significant change in males. We calculated the normal values for CP and VP in a healthy Japanese population. The results can contribute to the evaluation of patients' CPX results as a reference.

Comparison of tricuspid and mitral annular plane systolic excursion in determination of acute blood loss in healthy volunteers.

Ultrasound is used more and more in determining acute blood loss. This study is to compare tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE) measurement to determine volume loss pre and post blood donation in healthy volunteers. The systolic, diastolic and mean arterial blood pressures and pulses of the donors were measured in the standing and supine position by the attending physician, then, inferior vena cava (IVC), TAPSE and MAPSE measurements were made pre and post blood donation. Statistically significant differences were found in systolic blood pressure and pulse rate values that obtained in the standing position, and in the systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse values that obtained in the supine position (p < 0.05). The difference between IVC expiration (IVCexp) pre and post blood donation was 4.76 ± 2.94mm, and the difference in IVC inspiration (IVCins) was 2.73 ± 2.91mm. In addition, the MAPSE and TAPSE differences were 2.16 ± 1.4mm and 2.98 ± 2.13mm, respectively. Statistically significant differences were found between IVCins-exp, TAPSE and MAPSE values. TAPSE and MAPSE can be helpful in the early diagnosis of acute blood loss.

Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study.

Visit-to-visit variability (VVV) in blood pressure values has been reported in clinical studies. However, little is known about VVV in clinical practice and whether it is associated with patient characteristics in real-world setting. We conducted a retrospective cohort study to quantify VVV in systolic blood pressure (SBP) values in a real-world setting. We included adults (age ≥18 years) with at least 2 outpatient visits between January 1, 2014 and October 31, 2018 from Yale New Haven Health System. Patient-level measures of VVV included SD and coefficient of variation of a given patient's SBP across visits. We calculated patient-level VVV overall and by patient subgroups. We further developed a multilevel regression model to assess the extent to which VVV in SBP was explained by patient characteristics. The study population included 537 218 adults, with a total of 7 721 864 SBP measurements. The mean age was 53.4 (SD 19.0) years, 60.4% were women, 69.4% were non-Hispanic White, and 18.1% were on antihypertensive medications. Patients had a mean body mass index of 28.4 (5.9) kg/m2 and 22.6%, 8.0%, 9.7%, and 5.6% had a history of hypertension, diabetes, hyperlipidemia, and coronary artery disease, respectively. The mean number of visits per patient was 13.3, over an average period of 2.4 years. The mean (SD) intraindividual SD and coefficient of variation of SBP across visits were 10.6 (5.1) mm Hg and 0.08 (0.04). These measures of blood pressure variation were consistent across patient subgroups defined by demographic characteristics and medical history. In the multivariable linear regression model, only 4% of the variance in absolute standardized difference was attributable to patient characteristics. The VVV in real-world practice poses challenges for management of patients with hypertension based on blood pressure readings in outpatient settings and suggest the need to go beyond episodic clinic evaluation.

Prediction of Intradialytic Blood Pressure Variation Based on Big Data

Introduction: Cardiovascular (CV) events are the major cause of morbidity and mortality associated with blood pressure (BP) in hemodialysis (HD) patients. BP varies significantly during HD treatment, and the dramatic variation in BP is a well-recognized risk factor for increased mortality. The development of an intelligent system capable of predicting BP profiles for real-time monitoring is important. Our aim was to build a web-based system to predict changes in systolic BP (SBP) during HD. Methods: In this study, dialysis equipment connected to the Vital Info Portal gateway collected HD parameters that were linked to demographic data stored in the hospital information system. There were 3 types of patients: training, test, and new. A multiple linear regression model was built using the training group with SBP change as the dependent variable and dialysis parameters as the independent variables. We tested the model’s performance on test and new patient groups using coverage rates with different thresholds. The model’s performance was visualized using a web-based interactive system. Results: A total of 542,424 BP records were used for model building. The accuracy was greater than 80% in the prediction error range of 15%, and 20 mm Hg of true SBP in the test and new patient groups for the model of SBP changes suggested the good performance of our prediction model. In the analysis of absolute SBP values (5, 10, 15, 20, and 25 mm Hg), the accuracy of the SBP prediction increased as the threshold value increased. Discussion: This databae supported our prediction model in reducing the frequency of intradialytic SBP variability, which may help in clinical decision-making when a new patient receives HD treatment. Further investigations are needed to determine whether the introduction of the intelligent SBP prediction system decreases the incidence of CV events in HD patients.

Evaluation of Stress Response in Middle-Aged Male Diabetic Hypertensive Patients.

Stress triggers a cascade of reactions that alter the organism's dynamic steady state. There is a scarcity of interventional studies that show cortisol variability upon stress over time in groups of patients with chronic noncommunicable diseases and comorbidities. We aimed to examine salivary cortisol changes in the cognitive stress response of patients with hypertension and diabetes mellitus (HT&DM) and patients with hypertension (HT) and to determine differences between them. The study was conducted using a stress test of solving an arithmetic task in 62 patients with HT&DM and HT who were being treated in the outpatient clinic of the Medical Pharmacology and Clinical Pharmacology Department in Istanbul University, Istanbul Medical Faculty Hospital. There was no statistically significant difference between the HT&DM and HT groups for systolic blood pressure (SBP) and diastolic blood pressure (DBP) values (P = .331 and P = .058). When measured by repeated ANOVA, salivary cortisol level [F (1.842, 60) = 8.771, P < .0001], SBP [F (2.185, 60) = 12.080, P < .0001], DBP [F (2.793, 60) = 6.043, P = .001], and heart rate [F (2.073, 60) = 13.259, P < .0001] were statistically significant for the main effect (time), while the effect of the group × time interaction factor was statistically not significant (P = .773; P = .751; P = .713 and P = .506, respectively). The arithmetic problem-solving task used with the HT&DM and HT patients was useful as an acute stress test in the laboratory environment. There was no statistically significant difference for group × time interaction factor between the HT&DM and HT groups; however, the salivary cortisol and BP values increased significantly after acute stress within each group.

Antihypertensive activity of Moringa oleifera seeds hydroalcoholic extract on high sodium diet-induced hypertension in Wistar Rat

Our objective was to study the effect of hydroalcoholic extract of M. oleifera seeds on high blood pressure in Wistar rat. After 21 days of a high sodium diet, the value of systolic blood pressure and diastolic blood pressure increased from 87. 2 ± 1.96 / 58 ± 0.89 mm to 200.8 ± 0.49 /151.2 ± 1.2 mm Hg (p &lt; 0.05). Administered orally, the extract reduces the high blood pressure of hypertensive rats. It returns to its normal value after 19 days for the control batch, versus 9, 6, and 3 days for the animals treated with the extract at doses 100, 200, and 400 mg/kg (P &lt; 0.05). The extract also has a diuretic activity; the 24 h urinary volume increases from 4.8 ± 0.14 ml in control group, versus 6.85 ± 0.1, 8.3 ± 0.13 and 10.7 ± 0.5 ml in groups treated with the extract at doses 100, 200 and 400 mg/kg (p &lt; 0.05), while natriuresis increases from 2.06 ± 0.05 mEq/L in control group, versus 2.92 ± 0.05; 6.82 ± 0.11 and 10.73 ± 0.17 mEq/L in animals treated with the extract at doses 100, 200 and 400 mg/kg (p &lt; 0.05). In vitro, it relaxes the isolated aorta contracted with norepinephrine at the concentration of 10-5 M in the bath, with EC50 equal to 2.06 mg/ml (p &lt; 0.05). These results show that the hydroalcoholic extract of M. oleifera seeds has antihypertensive activity through its diuretic and vasodilator effects.

Age-dependent changes in arterial blood pressure in neonates during the first week of life: reference values and development of a model

BackgroundArterial pressure measurements are important to monitor vital function in neonates, and values are known to be dependent of gestational and postnatal age. Current reference ranges for mean arterial pressure in neonates have been derived from small samples and combined data of noninvasive and invasive measurements. We aimed to define reference values for noninvasive mean, systolic, and diastolic blood pressure during the first week of life in otherwise healthy preterm and term neonates defined by gestational and postnatal age. MethodsIn this retrospective cohort study in a neonatal intensive care unit (NICU) in a Dutch tertiary paediatric hospital, we included the noninvasive blood pressures of neonates admitted between 2016 and 2018, with exclusion of those with severe comorbidities (major cardiac malformations, intracerebral haemorrhage, and tracheal intubation >6 h). We defined the median (P50) with −2 standard deviations (sd) (P0.23), −1 sd (P16), +1 sd (P84), and +2 sd (P97.7) for gestational age and postnatal age using quantile regression, percentiles provided online (http://bloodpressure-neonate.com/). ResultsA total of 607 neonates, with 5885 measurements, fulfilled the inclusion criteria. The P50 values of mean noninvasive arterial blood pressure in extreme preterm infants steeply increased during the first day after birth and gradually increased within a week from 27 to 49 mm Hg at 24 h of gestational age, and from 49 to 61 mm Hg at 41 weeks of gestational age. ConclusionsThese reference values for noninvasive blood pressure in neonates in the NICU for various gestational age groups provide guidance for clinical decision-making in healthy and diseased neonates during anaesthesia and sedation.

Abstract P349: Predictive Value of Long-Term Systolic Blood Pressure Variability for the Development of Type 2 Diabetes Mellitus

Background: Better identification of high-risk individuals of type 2 diabetes mellitus (T2DM) for focused delivery of preventive measures requires risk prediction models using novel predictors. We evaluated the predictive value of long-term variability of systolic blood pressure (SBPV), which was recently reported to be associated with T2DM incidence, if added to a model with conventional T2DM predictors in a Japanese cohort study. Methods: A cohort of 3017 Japanese individuals (2446 male, 571 female) ages 36-65 years were followed from 2007 to 2019. Root-mean-square error (RMSE) and slope of systolic blood pressure (SBP) change regressed on year were calculated per individual using SBP values obtained consecutively from 2003 to 2007 to represent SBPV. An initial Cox model included age, sex, smoking status, regular exercise, family history of diabetes, body mass index (BMI), baseline SBP, blood levels of triglycerides (TG), high-density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG), and backward elimination was used for variable selection. The c-statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to compare the performance of prediction models without (Model 1) and with SBPV (Model 2). Results: During 9.8-year (median) follow-up, 135 developed T2DM. We confirmed that RMSE was significantly associated with T2DM incidence independent of other variables used in a conventional model. Backwards elimination procedure selected BMI, TG, HDLC, FBG, SBP RMSE, and SBP slope for the final model (Table 1). Although the c-indices were not statistically different between Model 1 (0.77) and Model 2 (0.78) as well as the NRI (7.1%), the IDI was statistically significant (0.8%, p&lt;0.05). Conclusions: The present study revealed that long-term variability of SBP slightly improved the predictive value of T2DM if added to a conventional prediction model.

Analysis of Physical Condition of First-Year Military Higher Education Institution Cadets

The purpose of the study was to determine the dynamics of anthropometric and functional indicators of the physical condition of first-year cadets over three years (from 2019 to 2021). Materials and methods. 152 cadets from Ivan Kozhedub Air Force National University were involved in the experiment. The age of participants was from 17 to 22 years. All cadets were informed about the experiment and gave their consent. Anthropometric (measurement of anthropometric data) and medical-biological (rhythm inversion, electromanometry) methods of investigation were used to determine the assessment of the cadets’ physical condition. A highly informative method – the assessment of O. Pirogova index was used for analysis of the cadets’ physical condition. Pirogova physical condition index is a complex indicator based on the heart rate, systolic and diastolic blood pressure, age, body weight, and body height. Statistical analysis of the results was carried out using the EXCEL tables. The data was analyzed using Student’s test, p less than 0.05 was considered the level of significance. Results and discussion. The results of the study showed that the mean values of the anthropometric and functional indicators of the first-year cadets have not been changed statistically significant over three years. The exception is the difference in the average value of systolic blood pressure of control group 1 and control group 3 representatives, which is statistically reliable (p &lt;0.05). Current anthropometric indicators of cadets obtained during the experiment confirmed the data available in the scientific and methodological literature about the anthropometric indicators of candidates for training in higher military educational institutions of Ukraine. The Pirogova physical condition index calculating showed the following average values of the Pirogova physical condition index: control group 1 – 0.704 points, control group 2 – 0.688 points, control group 3 – 0.671 points. However, the results of the study show a statistically significant deterioration of the Pirogova physical condition index of the 2021 recruitment cadets by 4.7% compared to the representatives of 2019. The comparative analysis of the first-year cadets' physical condition assessments demonstrates a gradual, significant decrease in the number of “high” physical condition ratings: 12% among control group 1 cadets (2019 year of recruitment); 9% among control group 2 representatives (2020 year of recruitment) and only 3% among control group 3 cadets (2021 year of recruitment). However, over three years, the percentage of representatives with physical condition assessment rating “Lower than average” has increased significantly: 1% among cadets of control group 1 (2019 year of recruitment); 7% among cadets of control group 2 (2020 year of recruitment); 7% among representatives of control group 3 (2021 year of recruitment). Conclusion. Over the last 3 years, there has been a deterioration of the general physical condition of higher military educational institution cadets