Blood Pressure Profile and Glycemic Control of Type 2 Diabetics and Hypertensives at the Yalgado Ouedraogo University Hospital: A Review of 116 Cases

Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.

Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control:A Randomized Clinical Trial

Objective Current clinical evidence on the effects of home blood pressure telemonitoring(HBPT)on improving blood pressure control comes entirely from developed countries.Thus,we performed this randomized controlled trial to evaluate whether HBPT plus support(patient education and clinician remote hypertension management)improves blood pressure control more than usual care(UC)in the Chinese population.Methods This single-center,randomized controlled study was conducted in Beijing,China.Patients aged 30-75 years were eligible for enrolment if they had blood pressure[systolic(SBP)≥140 mmHg and/or diastolic(DBP)≥90 mmHg;or SBP≥130 mmHg and/or DBP≥80 mmHg with diabetes].We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks.The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure.Results Totally,172 patients completed the study,the HBPT plus support group(n=84),and the UC group(n=88).Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group.The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the12th week of follow-up.Additionally,the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group.Conclusion HBPT plus additional support results in greater blood pressure reduction,better blood pressure control,a higher proportion of dipper blood pressure patterns,lower blood pressure variability,and higher drug adherence than UC.The development of telemedicine may be the cornerstone of hypertension management in primary care.

Hygienic and Dietary Measures in Cameroonian Hypertensive Patients Followed at the Douala General Hospital: Knowledge, Compliance and Effect on Blood Pressure Control

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the Douala General Hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the Douala General Hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

Clinical Analysis of Diabetic Nephropathy Risk Factors and Correlation with Blood Pressure Control

Objective:To explore the risk factors of diabetic nephropathy and its correlation with blood pressure control.Methods:A retrospective analysis of 80 patients with diabetic nephropathy(diabetic nephropathy group)and another 80 patients with diabetes(diabetic group)who were admitted to the Department of Nephrology and Endocrinology at our hospital from October 2021 to October 2022 was conducted.The general data of the two groups were compared,the influencing factors associated with the two groups were analyzed unilaterally,and unconditional dichotomous logistic regression was performed to analyze the influencing factors in patients with diabetic nephropathy.Results:There were no significant differences in high-density lipoprotein,systolic blood pressure,diastolic blood pressure,and creatinine between the two groups(P>0.05);however,compared with the diabetic group,the DN group had significantly elevated glycated hemoglobin,low-density lipoprotein,24-h urine protein,insulin resistance,and diabetes duration≥10 years(P<0.05).Conclusion:The clinical research on the correlation between the incidence of hypertension and the control of blood pressure in patients with diabetic nephropathy should be strengthened in order to formulate reasonable and feasible treatment plans.

Evaluation of the effects of health education interventions for hypertensive patients based on the health belief model

BACKGROUND Hypertension is a major risk factor for cardiovascular disease and stroke,and its prevalence is increasing worldwide.Health education interventions based on the health belief model(HBM)can improve the knowledge,attitudes,and behaviors of patients with hypertension and help them control their blood pressure.AIM To evaluate the effects of health education interventions based on the HBM in patients with hypertension in China.METHODS Between 2021 and 2023,140 patients with hypertension were randomly assigned to either the intervention or control group.The intervention group received health education based on the HBM,including lectures,brochures,videos,and counseling sessions,whereas the control group received routine care.Outcomes were measured at baseline,three months,and six months after the intervention and included blood pressure,medication adherence,self-efficacy,and perceived benefits,barriers,susceptibility,and severity.RESULTS The intervention group had significantly lower systolic blood pressure[mean difference(MD):-8.2 mmHg,P<0.001]and diastolic blood pressure(MD:-5.1 mmHg,P=0.002)compared to the control group at six months.The intervention group also had higher medication adherence(MD:1.8,P<0.001),self-efficacy(MD:12.4,P<0.001),perceived benefits(MD:3.2,P<0.001),lower perceived barriers(MD:-2.6,P=0.001),higher perceived susceptibility(MD:2.8,P=0.002),and higher perceived severity(MD:3.1,P<0.001)than the control group at six months.CONCLUSION Health education interventions based on the HBM effectively improve blood pressure control and health beliefs in patients with hypertension and should be implemented in clinical practice and community settings.

Single-Arm Clinical Study of Combination Perindopril-Amlodipine Tablets in the Treatment of High-Altitude Hypertension

Objective:To evaluate the efficacy of combination perindopril/amlodipine tablets in patients with high-altitude hypertension who were previously unable to control their blood pressure with monotherapy.Methods:A total of 151 patients with high-altitude hypertension whose blood pressure remained inadequately controlled with previous monotherapy were enrolled in this study.All patients received an 8-week treatment with a combination of perindopril/amlodipine tablets,consisting of perindopril 10 mg/day and amlodipine 5 mg/day.Blood pressure measurements,including both diastolic and systolic pressures,were taken at baseline,and after 2,4,6,and 8 weeks of treatment.Results:After 8 weeks of treatment,there was a significant reduction in both average systolic and diastolic blood pressure compared to baseline(P<0.0001).Specifically,the average systolic blood pressure decreased by 24.45±13.75 mmHg,and the average diastolic blood pressure decreased by 13.37±8.40 mmHg.The overall heart rate showed no significant changes during the treatment period.Conclusion:A combination of perindopril/amlodipine tablets significantly improved blood pressure control in patients with high-altitude hypertension after 8 weeks of treatment.These results support the efficacy of combination perindopril/amlodipine as a viable treatment option for high-altitude hypertension.

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.

Automated postoperative blood pressure control

It is very important to maintain the level of mean arterial pressure （MAP）. The MAP control is applied in many clinical situations, including limiting bleeding during cardiac surgery and promoting healing for patient＇ s post-surgery. This paper presents a fuzzy controller-based multiple-model adaptive control system for postoperative blood pressure management. Multiple-model adaptive control （MMAC） algorithm is used to identify the patient model, and it is a feasible system identification method even in the presence of large noise. Fuzzy control （FC） method is used to design controller bank. Each fuzzy controller in the controller bank is in fact a nonlinear proportional-integral （PI） controller,whose proportional gain and integral gain are adjusted continuously according to error and rate of change of error of the plant output, resulting in better dynamic and stable control performance than the regular PI controller, especially when a nonlinear process is involved. For demonstration, a nonlinear, pulsatile-flow patient model is used for simulation, and the results show that the adaptive control system can effectively handle the changes in patient＇s dynamics and provide satisfactory performance in regulation of blood pressure of hypertension patients.

Numerical study of biomechanical characteristics of plaque rupture at stenosed carotid bifurcation:a stenosis mechanical property-specific guide for blood pressure control in daily activities

Acute stress concentration plays an important role in plaque rupture and may cause stroke or myocardial infarction.Quantitative evaluation of the relation between in vivo plaque stress and variations in blood pressure and flow rates is valuable to optimize daily monitoring of the cardiovascular system for high-risk patients as well as to set a safe physical exercise intensity for better quality of life.In this study,we constructed an in vivo stress model for a human carotid bifurcation with atherosclerotic plaque,and analyzed the effects of blood pressure,flow rates,plaque stiffness,and stenosis on the elastic stress and fluid viscous stress around the plaque.According to the maximum values of the mechanical stress,we define a risk index to predict the risk level of plaque rupture under different exercise intensities.For a carotid bifurcation where the blood flow divides,the results suggest that the stenosis ratio determines the ratio of the contributions of elastic shear stress and viscous shear stress to plaque rupture.A n increase of the plaque stiffness enhances the maximum elastic shear stress in the plaque,indicating that a high-stiffness plaque is more prone to rupture for given stenosis ratio.High stress co-localization at the shoulder of plaques agrees with the region of plaque injury in clinical observations.It is demonstrated that,due to the stress-shield effect,the rupture risk of a high-stiffness plaque tends to decrease under high-stenosis conditions,suggesting the existence of a specific stenosis corresponding to the maximum risk.This study may help to complement risk stratification of vulnerable plaques in clinical practice and provides a stenosis mechanical property-specific guide for blood pressure control in cardiovascular health management.

Establishment of blood glucose control model in diabetic mice

AIM:To explore the established method of the diabetic mouse blood glucose control model and preliminar y observation of its influence on the retinas of diabetic mice.METHODS:The db/db BKS-DB(Lepr^(ko/ko))mice were randomly divided into two groups:the poor blood glucose control group(PG group,n=18)and the stable blood glucose control group(SG group,n=12),with BKS-DB(Lepr^(wt/wt))as the normal blood glucose control group(NG group,n=18).According to the blood glucose values for 5 intervals which were monitored during the period of adaption,the PG group was injected with insulin aspart twice daily,fasted for 2h and then returned to normal.The SG group was injected with insulin aspart twice and insulin glargine once daily and fed with a quantitative ration.Fundus images were collected after eight weeks.The glycosylated hemoglobin(Hb A1c),mean blood glucose level(MBG),standard deviation of blood glucose(SDBG),coefficient of variation of blood glucose(CVBG),and mean amplitude of glycemic excursion(MAGE)in each group were examined and calculated.RESULTS:The Hb A1c,MBG,SDBG,CVBG,and MAGE levels in the PG group were significantly higher than those in the NG and SG groups(all P<0.05).MBG,SDBG,CVBG,and MAGE levels in the SG group were higher than those in the NG group(all P<0.05).There was no significant difference in Hb A1c levels between the NG and SG groups(P>0.05).Preliminary observation of fundus images in the PG group and SG groups showed scattered retinal bleeding spots,while bleeding was more obvious in the PG group.CONCLUSION:The blood glucose control model of type 2 diabetes mellitus mice can be successfully established by subcutaneous injection of insulin aspart insulin glargine and rationed food,which is valuable for studying the mechanism of blood glucose fluctuations in diabetic complications in vivo.

Direct evidence of VEGF-mediated neuroregulation and afferent explanation of blood pressure dysregulation during angiogenic therapy

Objective:Oncocardiology is increasingly hot research field/topic in the clinical management of cancer with anti-angiogenic therapy of vascular endothelial growth factor(VEGF)that may cause cardiovascular toxicity,such as hypertension via vascular dysfunction and attenuation of eNOS/NO signaling in the baroreflex afferent pathway.The aim of the current study was to evaluate the potential roles of VEGF/VEGF receptors(VEGFRs)expressed in the baroreflex afferent pathway in autonomic control of blood pressure(BP)regulation.Methods:The distribution and expression of VEGF/VEGFRs were detected in the nodose ganglia(NG)and nucleus of tractus solitary(NTS)using immunostaining and molecular approaches.The direct role of VEGF was tested by NG microinjection under physiological and hypertensive conditions.Results:Immunostaining data showed that either VEGF or VEGFR2/VEGFR3 was clearly detected in the NG and NTS of adult male rats.Microinjection of VEGF directly into the NG reduced the mean blood pressure(MBP)dose-dependently,which was less dramatic in renovascular hypertension(RVH)rats,suggesting the VEGF-mediated depressor response by direct activation of the 1st-order baroreceptor neurons in the NG under both normal and disease conditions.Notably,this reduced depressor response in RVH rats was directly caused by the downregulation of VEGFR2,which compensated the up regulation of VEGF/VEGFR3 in the NG during the development of hypertension.Conclusion:It demonstrated for the first time that the BP-lowering property of VEGF/VEGFRs signaling via the activation of baroreflex afferent function may be a common target/pathway leading to BP dysregulation in anti-angiogenic therapy.

Analysis on the Correlation between Fasting Blood-glucose and Gestational Diabetes Mellitus

Objective： The correlation between the fasting blood-glucose （FBG） in early pregnancy and the gestational diabetes mellitus （GDM） was studied. Methods： The clinical data of 300 pregnant women receiving a treatment from Yongqing Hospital of Traditional Chinese Medicine and Langfang Health Vocational College from September 2012 to September 2013 was chosen; these cases were divided into group 6.9-6.0 mmol/L （35 cases）, group 5.9~5.0 mmol/L （58 cases）, group 4.9~4.5 mmol/L （120 cases）, and group 4.4~4.0mmol/L （108 cases） according to the range of the normal FBG. The proportional differences among the pregnant women diagnosed with GDM in different groups during the late pregnancy as well as the maternal and fetal prognosis were compared. Results： The proportion of the pregnant women diagnosed with GDM in group 6.9-6.0 mmol/L and group 5.9-5.0 mmol/L during the middle-late pregnancy was significantly higher than that of group 4.9-4.5 mmol/L and group 4.4-4.0mmol/L; there was no significant proportional difference among the pregnant women diagnosed with GDM in group 6.9~6.0 mmol/L and group 5.9-5.0 mmol/L during the middle-late pregnancy; there was no significant proportional difference among the pregnant women diagnosed with GDM in group 4.9-4.5 mmol/L and group 4.4-4.0mmol/L during the middle-late pregnancy. Conclusion： The risk of the pregnant women with FBG is higher than that of the normal pregnant women in suffering GDM during the early pregnancy, so attention should be paid to early blood glucose test and the blood glucose level should be positively controlled once they are defmitely diagnosed with GDM, and then the perinatal and maternal survival quality can be improved.

Investigation on Blood Glucose Control Nursing of ICU Severe Patients

Objective:To analyze the effect of blood glucose control mursing in intensive care umit (ICU)patients.Methods:The clinical data of 70 severe patients in ICU of ou hospital fom January 2019 to May 2020 were retrospectively analyzed.The climical data of 34 patients with routine intervention were divided into the control group,and the clinical data of 36 patients with routine intervention and blood glucose control mursing were divided into the observation group,all were intervened for 14 days.The blood glucose levels and prognosis of the two groups were compared before intervention and at the end of 14 days of intervention,the time required o achieve the standard blood glucose level of the two groups was recorded Results:After 14 days of intervention,the fasting blood glucose level of the observation group was lower than the control group,the difference was satisically significant(P<0.05);the time of blood glucose reaching the standard in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);on the 14th day of intervention,the sequential organ failure asessment score(SOFA)score of the two groups was lower than before intervention,the SOFA score of the observation group was lower than control group,the difference was statistically significant(P<0.05).Conclusion:The effect of blood glucose control mursing in ICU is better,which effectively controlled the blood glucose level of patients and improved the prognosis of patients.

Home Blood Pressure Monitoring and Its Association With Blood Pressure Control Among Hypertensive Patients With High Cardiovascular Risk in China

Objective:Home blood pressure monitoring(HBPM)is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension.However,evidence remains scarce about the effectiveness of HBPM use in the real world.This study aimed to examine the associations of HBPM use with blood pressure(BP)control and medication adherence.Methods:This prospective cohort study included hypertensive patients with high cardiovascular risk who were aged≥50 years.At baseline,information about types of BP monitor,frequency of HBPM,perception of anti-hypertensive treatment,and measured office BP were collected.During the 1-year follow-up(visits at 1,2,3,6,and 12 months),information on medication adherence was collected at each visit.The 2 major outcomes were BP control at baseline and medication adherence during the 1-year follow-up.A log-binomial regression model was used to examine the association between frequency of HBPM and outcomes,stratified by the perceptions of anti-hypertensive treatment.Results:A total of 5,363 hypertensive patients were included in the analysis.The age was(64.6±7.2)years,and 41.2%(2,208)were female.Of the total patients,85.9%(4,606)had a home BP monitor and 47.8%(2,564)had an incorrect perception of anti-hypertensive treatment.Overall,24.2%(1,299)of patients monitored their BP daily,37.6%(2,015)weekly,17.3%(926)monthly,and 20.9%(1,123)less than monthly.At baseline,the systolic BP and diastolic BP were(146.6±10.8)mmHg and(81.9±10.6)mmHg,respectively,and 28.5%(1,527)of patients had their BP controlled.Regardless of whether the patients had correct or incorrect perceptions of anti-hypertensive treatment,there is no significant association between HBPM frequency and BP control at baseline.During the 1-year follow-up,23.9%(1,280)of patients had non-adherence to medications at least once.In patients with an incorrect perception of anti-hypertensive treatment,those monitoring BP most frequently(daily)had the highest non-adherence rate(29.9%,175/585).Compared with those monitoring their BP less than monthly,patients who monitored their BP daily were more likely not to adhere to anti-hypertensive medications(adjusted relative risk=1.38,95%confidence interval:1.11–1.72,P=0.004).Conclusions:HBPM performance among hypertensive patients in China is,in general,sub-optimal.No association was observed between using HBPM alone and hypertension control,indicating that the effects of HBPM could be conditional.Patients’misconceptions about anti-hypertensive treatment may impair the role of BP monitoring in achieving medication adherence.Fully incorporating the correct perception of hypertension into the management of hypertensive patients is needed.

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus

Type 2 diabetes mellitus （T2DM） is one of the common endocrinology diseases that greatly affects the health care sector and economy. Application of hypoglycemic drugs has its own drawbacks and the use of non-drug therapy on treating T2DM has drawn much attention recently. This paper reviewed the research development of the non-pharmacological interventions on T2DM in recent years, including dietary therapy, exercise therapy, psychotherapy, acupuncture and moxibustion therapies and so on. The authors mentioned the problems in the research of non-drug treatment for blood glucose control of T2DM and put forward new ideas for the research in the future. Further well-designed trials with large sample size and long-term follow-up are needed to confirm current conclusions.

The Effect of Baihu Decoction (白虎汤) on Blood Glucose Levels in Treating Systemic Inflammatory Response Syndrome

In this paper we investigated the mechanisms of Baihu Decoction （白虎汤, BH） and Baihu with Radix Ginseng （BHG） in treating systemic inflammatory response syndrome （SIRS） and sepsis in humans and animals. By reviewing published data on the effects of BH and BHG and the control of blood glucose in treating SIRS and sepsis, we found that （1） BH and BHG were beneficial in the treatment of SIRS and sepsis in humans and animals; （2） BH and BHG also had great effect in lowering blood glucose level; and （3） the tight control of blood glucose during critical illness substantially improved the outcome. Considering these data together, we hypothesize that one of the major mechanisms of BH and BHG in treating SIRS and sepsis is to lower the blood glucose level. The findings also suggest that the application of BH and BHG can extend to many acute illnesses and injuries, which commonly cause hyperglycemia.

Ambulatory blood pressure monitoring for the management of hypertension

Ambulatory blood pressure monitoring(ABPM)has become indispensable in the current management of hypertension.ABPM is particularly useful in the accurate diagnosis of hypertension.Its diagnostic thresholds had been recently established based on hard clinical outcomes.Cross-classification of patients according to office and ambulatory blood pressure identifies white-coat,masked,and sustained hypertension.ABPM is also useful in cardiovascular(CV)risk assessment.It provides information on daytime and nighttime blood pressure and circadian rhythm,particularly nighttime blood pressure dipping.Nighttime blood pressure is predictive of CV risk independent of office and daytime blood pressure.Isolated nocturnal hypertension is a special form of masked hypertension,with normal daytime but elevated nocturnal blood pressure.It also helps in the evaluation of blood pressure fluctuation and variation,such as morning blood pressure surge and reading-to-reading blood pressure variability.ABPM may derive several other indexes,such as ambulatory blood pressure index and salt sensitivity index,which may be useful in CV evaluations.

Impact of blood pressure control on coronary flow reserve in hypertensive patients

Objective To investigate the impacts of blood pressure control on coronary flow reserve(CFR)in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis(defined as<50%luminal narrowing confirmed by coronary angiography or coronary artery CT scan)between January 2011 and July 2015were retrospectively enrolled in this study.CFR

Glucose-responsive erythrocyte-bound nanoparticles for continuously modulated insulin release

Glucose-responsive closed-loop insulin delivery systems represent a promising treatment strategy for diabetes,but current systems generally cannot achieve long-term effects.In this study,we designed an erythrocyte-biomimetic glucose-responsive system(EGRS)by coupling glucose-responsive nanoparticles(GRNs)to red blood cells;these nanoparticles exhibited the dual functions of glucose-responsiveness and persistent presence in circulation.GRNs are generated by encapsulating with insulin through ion crosslinking,followed by coloading with glucose oxidase(GOx)and catalase(CAT),a process that endows the nanoparticles with glucose-responsiveness.Simultaneously,the GRNs are coupled with red blood cells to camouflage them from the immune system,therefore,these erythrocyte-coupled GRNs can circulate in the blood for a long time.Under conditions of hyperglycemia,GOx acts on blood glucose to produce gluconic acid,which causes the rupture of GRNs and efficient release of insulin.Conversely,insulin is only released at the basic rate during hypoglycemia.Thus,EGRS can efficiently and continuously respond to hyperglycemia to maintain blood glucose levels within the normal range.