Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)a...Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.展开更多
AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude(OPA). METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study...AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude(OPA). METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study. BMI (kg/m2) was calculated for every individual. IOP and OPA were measured with Pascal Dynamic contour tonometer (DCT). Blood pressure was also measured along with the DCT. The patients were divided into three groups according to BMI as: Group1, BMI<25; Group2, 25≤BMI<30; Group3, BMI≥30. Mean values of IOP, OPA, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used in statistical analysis.RESULTS: In Group1, the means of IOP, OPA, were 16.8±2.3mmHg, 2.7±0.7mmHg respectively; and SBP, DBP were 120.0±6.1mmHg, and 77.4±5.6mmHg respectively. In group2, the mean IOP, OPA, SBP, and DBP were found to be 16.6±2.1mmHg, 2.4±0.7mmHg, 121.7±5.3mmHg, and 79.5±4.9mmHg respectively. In group3, the mean IOP, OPA, SBP, and DBP were found to be 17.3±1.7mmHg, 2.1±0.7mmHg, 122.4±5.7mmHg, and 79.7±5.2mmHg respectively. There were no statistically significant difference between groups in terms of IOP, SBP and DBP, while OPA values were significantly lower in group3 (P=0.001). CONCLUSION: Decreased OPA values in individuals with higher BMI may indicate that subjects with higher BMI have lower choroidal perfusion and lower ocular blood flow.展开更多
A slight reduction of blood pressure and heart rate can reduce the risk of developing cardiovascular disease. Maintenance of the respiratory rate within the normal range has also being identified as crucial for a heal...A slight reduction of blood pressure and heart rate can reduce the risk of developing cardiovascular disease. Maintenance of the respiratory rate within the normal range has also being identified as crucial for a healthy heart. Use of Indian and western music have been considered among many preventive programmes for long time in order to risk reduction associated with cardio vascular diseases. Therefore the aim of this study is to describe the effect of Indian classical music on systolic and diastolic blood pressure, pulse rate and respiratory rate in asymptomatic individuals aged 45 to 65 years. Methodology: A community based randomized intervention study was conducted in 252 asymptomatic individuals. The study group (n = 127) listened to a music based on Indian classical system (entire track of 22 minutes). The control group (n = 125) was kept silent for a similar time period. Systolic and diastolic blood pressure, pulse rate and respiratory rate of each study participant were monitored before and after the intervention. Results: Statistically significant reduction in systolic blood pressure (8.53 mmHg), diastolic blood pressure (5.8 mmHg), pulse rate (5.16 breaths per minute) and respiratory rate (2.55 per minute) were observed in the study group after listening to the music (p < 0.01). In the control group, changes observed during the period of intervention were not significant (p > 0.05). The reduction was independent of gender, age, education level, practicing a mind relaxation technique and preferred type of music of the participant. Conclusions: Listening to Indian classical music for about 22 minutes significantly reduced systolic and diastolic blood pressure, pulse rate and respiratory rate of asymptomatic individuals. Hence, music may have a potential benefit in cardio vascular disease preventive programmes.展开更多
A noninvasive method for monitoring blood pressure, based on the principles established by Riva-Rocci and Korotkoff (K), is described;it furnishes, after a single compression-deflation cycle of the arm-encircling cuff...A noninvasive method for monitoring blood pressure, based on the principles established by Riva-Rocci and Korotkoff (K), is described;it furnishes, after a single compression-deflation cycle of the arm-encircling cuff, values of sys-tolic and diastolic blood pressures as well as the contours of the brachial arterial pulse and the corresponding volume pulse. K-sounds are detected by a single microphone situated in the cubital fossa, and the time-varying cuff pressure P(t) is read by a piezoresistive pressure sensor. The behavior of P(t) during deflation is resolved into two parts, P(t)=p(t)+b(t);p is a train of posi-tive going pulses (arising from arterial pulsa-tions), whereas b is a slowly changing baseline. Noise pulses in the microphone output are re-jected by using the observation that the first few K-sounds are emitted when p is close to a maxi-mum, and the last few when dp/dt is close to a maximum. The performance of the instrument is illustrated by showing how it copes with ambi-ent noise and involuntary manual perturbations of P, and by presenting contours of various pulses.展开更多
Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compare...Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest,during LBNP (10,20 and 30 mmHg,each for 15 min) and after NTG (10,30 and 100 μg/min,each dose for 15 min) in ten healthy volunteers. Cardiac pre-load,stroke volume and cardiac output were assessed by echocardiography. Central pressure augmentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results LBNP (20 mmHg) and NTG (30 μg/min) reduced pre-load (as measured by the peak velocity of the S wave in the superior vena cava) to a similar degree [by (26.8±3.8)% and (23.9±3.4)%,respectively]. Compared to LBNP,NTG reduced systemic vascular resistance [by (32.9±7.5)%,P<0.01],decreased peripheral and central pressure augmentation [by (20.8±3.4)% units and (12.9±2.9)% units,respectively,each P<0.01]. Conclusion These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.展开更多
Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk...Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk of mortality. Aim: The aim was to identify the associations with absolute values of ΔSBP (|ΔSBP|) ≥10 mm Hg. Subjects and Methods: This study included 2481 patients. Patients with a body mass index ≥25 kg/m<sup>2</sup> were defined as obese. The group of A was defined as following: ankle-brachial index (ABI) was <0.9 or ≥1.3. ΔSBP was expressed as right arm BP minus left arm BP. |ΔSBP| ≥10 mm Hg were analyzed using multivariate logistic analysis. Results: |ΔSBP| ≥10 mm Hg was found in 6.0% of patients and |ΔSBP| < 5 mm Hg in 80.4%. In multivariate analysis, the odds ratios (ORs) of the associations with |ΔSBP| ≥10 mm Hg were significantly associated with abnormal ABI and obesity regardless of sex and age. Moreover, the OR of the combined effects of abnormal ABI and obesity was higher than that of abnormal ABI and obesity alone. Conclusion: |ΔSBP| ≥10 mm Hg was associated with abnormal ABI and obesity. In a primary care setting, blood pressure should be actively measured in both arms. This study suggests that the associations with |ΔSBP| ≥10 mm Hg may be a useful part of screening for abnormal ABI.展开更多
Continuous non-invasive blood pressure (BP) measurement can be realized by using pulse transit time (PTT) based on electrocardiogram (ECG) and pulse wave signal. Modulated magnetic signature of blood (MMSB) is a promi...Continuous non-invasive blood pressure (BP) measurement can be realized by using pulse transit time (PTT) based on electrocardiogram (ECG) and pulse wave signal. Modulated magnetic signature of blood (MMSB) is a promising approach to obtain PTT. The origin of MMSB is critical to establish the relationship between MMSB and BP. In this paper, two possible origins of MMSB, blood disturbance mechanism and angular variation mechanism, are analyzed and verified through three control experi-ments under different conditions. The influence of blood velocity alteration and blood volume alteration on magnetic field is investigated though blood flow simulation sys-tem. It is found that MMSB comes mainly from the periodic blood flow while the per-turbation caused by angular variation between sensitive axis of the magnetic sensor and geomagnetic field can be neglected. As to blood disturbance mechanism, the change of blood volume plays a decisive role while the effect of blood velocity altera-tion is negligible.展开更多
Objective To compare the effect of chemomechanical caries removal (CMCR) to traditional drilling (TD) on blood pressure and pulse in children. Methods Of all 105 subjects, 53 were randomly assigned to CMCR group; ...Objective To compare the effect of chemomechanical caries removal (CMCR) to traditional drilling (TD) on blood pressure and pulse in children. Methods Of all 105 subjects, 53 were randomly assigned to CMCR group; 52, to TD group. For each subject, the systolic pressure (SP), diastolic pressure (DP) and pulse ( P ) were measured at five time-point: pre-treatment, initiation of carious removal, the end of carious removal, the end of the cavity restoration, and the end of the dental care. They were recorded as To, T1 , T2, T3, and TE, respectively. The difference of SP, DP, and P within each group were analyzed. Results Of all 105 subjects, 14 were administered local anesthesia. Since local anesthesia may be a confounding factor for changes in blood pressure and pulse, only the data of the other 91 subjects that local anesthesia were not administered were analyzed. Regarding the SP, DP, and P for TD, the difference between TO and T1 was significant ( P = 0. 013, 0. 015, 0. 012 respectively), while not significant between T1 and T2, T2 and T3, T3 and TE( P 〉0. 05). Regarding the SP, DP, and P for CMCR, the differences were not significant between every two consecutive time-points ( P 〉 0. 05). The differences of the SP, DP, and P between CMCR and TD were not significant for time-points T0, T3 and Te (p 〉 0. 05 ), while significant for T1 and T2 ( P 〈 0. 05 ). Conclusion In general, CMCR induces less increase of blood pressure and pulse in children compared to traditional drilling (TD). It may be inferred that CMCR is less distressing than TD.展开更多
To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the ge...To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m<sup>2</sup> in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.展开更多
Objective To estimate the prevalence of elevated blood pressure(EBP) in Chinese children and identify individual and family factors associated with EBP. Methods A nationwide cross-sectional study was conducted in 20...Objective To estimate the prevalence of elevated blood pressure(EBP) in Chinese children and identify individual and family factors associated with EBP. Methods A nationwide cross-sectional study was conducted in 2010 using stratified cluster sampling. Participants' blood pressure was measured, and their parents completed a questionnaire on personal and family characteristics. Prevalence and correlates of EBP were assessed. Results Among a total of 24,333 participants, 20.2% of boys and 16.3% of girls had EBP. The prevalence of EBP increased with the ascending trend of waist circumference, Waist-to-height ratio, and body mass index. The adjusted prevalence ratios(aP Rs) for obese boys and girls were 2.50 and 2.97, respectively. Fewer urban boys(16.2%) had EBP than rural boys(21.7%). Boys with a family history of hypertension were 12% more likely to have EBP. Children whose mothers received a college education tended to have lower likelihood of EBP; with an aP R was 0.85 among boys and 0.78 among girls. Conclusion EBP is common among obese students and those who have a family history of hypertension. A negative association between mothers' education levels and EBP risk in children was found.展开更多
The importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), on the incidence of coronary heart disease (CHD) and stroke are known. However, the importance of blood pressur...The importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), on the incidence of coronary heart disease (CHD) and stroke are known. However, the importance of blood pressure (BP)-age shifts regarding the stroke incidence is not clearly known. The BP changes with the advancement of age from the predominance of DBP in the young to the predominance of SBP in the old. This change is due to the stiffening of the large arteries as a result of the aging process and the replacement of the elastic fibers with collagen fibers. This change results in the loss of compliance and the elastic recoil of these vessels leading to increase in pulse wave velocity, central SBP and widening of pulse pressure leading to an increased incidence of CHD and strokes. It has been demonstrated epidemiologically that the SBP rises linearly with age, whereas the DBP rises up to the age of 45-50 years, and then begins to decline after the age of 60 years leading to a progressive widening of PP. Several studies have shown an inverse relationship between DBP and CHD, whereas no such relationship has been demonstrated for stroke. However, a recent study showed an inverse relationship with DBP and stroke when it dropped below 71 mmHg in subjects 50 years of age or older. In contrast, there was a positive association between BP and stroke when both SBP and DBP were ≥ 71 mmHg. These findings suggest that intreating systolic hypertension in the elderly to reduce stroke risk, attention should be paid on the potential harm of low DBP and the widening of PP regarding CHD and stroke. The implications of BP shifts with age and the potential risks of low DBP regarding the risk of stroke will be discussed in this concise review.展开更多
Because of the paucity of serial blood pressure data on the same individuals, little is known about the accuracy of elevated blood pressure (BP) in childhood for predicting hypertension (HBP) later in life. The availa...Because of the paucity of serial blood pressure data on the same individuals, little is known about the accuracy of elevated blood pressure (BP) in childhood for predicting hypertension (HBP) later in life. The availability of long-term serial BP data from the Fels Longitudinal Study (FLS) presents the opportunity to link HBP in adulthood directly to BP measured decades earlier in the same individuals as children. We analyzed serial data from 965 men and 1114 women in the FLS. We used an autoregressive-moving average (1, 1) [ARMA (1, 1)] longitudinal model to predict adult HBP from childhood values. For 15-year-old boys with SBP 15 mmHg and 30 mmHg above the average SBP of 90 mmHg, the probabilities of having HBP at age 35 are 0.18 and 0.33, respectively. The corresponding probabilities for 15-year-old girls are only 0.04 and 0.08. This striking sex difference in risk of HBP at age 35 between 15-year-old boys and girls indicates that the risk of developing HBP in women is low regardless of their childhood blood pressure at any age from 2 to 17 years. Men are about 4.25 times more likely to have HBP at age 35 than women over a range of SBP of 90 - 140 mmHg at age 15. The ARMA (1, 1) model allows the identification of boys at risk for HBP as adult men.展开更多
The principle for blood pressure measurement using pulse transit time is introduced in this paper.And the math model of synergetics theory is studied in detail.The synergetics theory is applied in the analysis of bloo...The principle for blood pressure measurement using pulse transit time is introduced in this paper.And the math model of synergetics theory is studied in detail.The synergetics theory is applied in the analysis of blood pressure measurement data.The simulation results show that the application of synergetics theory is helpful to judge the normal blood pressure,and the accuracy is up to 80%.展开更多
In recent years, the demand for almond milk and its sales has increased owing to consumers’ perceptions about its health benefits. Hence, we sought to measure the effect of almond milk on body measurements such as bo...In recent years, the demand for almond milk and its sales has increased owing to consumers’ perceptions about its health benefits. Hence, we sought to measure the effect of almond milk on body measurements such as body weight, body mass index and waist and hip circumference, in addition to diastolic and systolic blood pressures. Thirty volunteers of both sexes participated in the study, with a mean age of 23.27 ± 6.20 years. The study was conducted over 4 weeks, and the results showed that daily substitution of one serving of dairy product with one cup (240 ML) of almond milk significantly decreased body weight, body mass index and waist and hip circumference, However, no effects were observed on blood pressures.展开更多
Continuous measurement of blood pressure based on pulse transit time (PTT) using GMR sensors is the state-of-art non-invasive cuffless method in which modulated magnetic signature of blood (MMSB) is used. In this pape...Continuous measurement of blood pressure based on pulse transit time (PTT) using GMR sensors is the state-of-art non-invasive cuffless method in which modulated magnetic signature of blood (MMSB) is used. In this paper, the mechanism of MMSB is investigated. According to the experimental results, it is found that both blood pulse flowing through the applied magnetic field and the displacement of the GMR sensor caused by blood pulse contribute to the disturbance of magnetic field detected by GMR sensors. The feasibility of MMSB method is discussed as well.展开更多
Blood pressure is an important physiological parameter to reflect human vital signs.In order to achieve the non-contact dynamic blood pressure acquisition based on ordinary optical camera,a theoretical understanding o...Blood pressure is an important physiological parameter to reflect human vital signs.In order to achieve the non-contact dynamic blood pressure acquisition based on ordinary optical camera,a theoretical understanding of the functional relationship between blood pressure and pulse wave signal conduction time.And through imaging photoelectric plethysmography(IPPG),pulse wave signal conduction time of forehead and hand was obtained with ordinary optical camera.First,the pulse wave conduction time was obtained by recording the video with an ordinary optical camera.Second,real-time blood pressure values were collected.Finally,based on the relationship between blood pressure and pulse wave conduction time,a non-contact blood pressure measurement prediction model was obtained through neural network fitting.So that non-contact blood pressure measurement with optical camera could be completed.The method in this paper has several advantages,such as low requirements on measuring equipment,low cost,and simple operation.It can let people get rid of the discomfort caused by measuring equipment such as cuff and can measure blood pressure at any time.The predicted blood pressure results were compared with an Omron wrist electronic sphygmomanometer.The calculated error of systolic blood pressure is-9.28%~3.16%,and the error of diastolic blood pressure is-9.84~4.35%.展开更多
<div style="text-align:justify;"> <strong>Introduction-Purpose: </strong><span "="">Pulsed pressure is recognized as an important predictor of cardiovascular risk. The ...<div style="text-align:justify;"> <strong>Introduction-Purpose: </strong><span "="">Pulsed pressure is recognized as an important predictor of cardiovascular risk. The purpose of this study was to identify a possible association between high ambulatory pulsed pressure and left ventricular geometry change in African black people. <b>Material and methods:</b> We conducted a bicentric, retrospective descriptive and analytical study that took place from 2010 to 2015 at the Abidjan Heart Institute and the Polyclinic Sainte Anne Marie in Abidjan. The people were selected from MAPA’s archive files. Those aged 18 years and over were included, all of whom had valid echocardiography and MAPA. The analyzed parameters concerned epidemiological data with age, gender and body surface area. The clinical data analyzed included systolic, diastolic, mean and 24-hours pulsed pressures. On the echocardiographic parameters, it was the evaluation of the ventricular mass indexed to the body surface. <b>Results: </b>A total of 177</span> patients records were selected. The mean age of the patients was 56.32 ± 10.51 years. There was a male predominance with a sex ratio of 1.15. The main cardiovascular risk factors found outside high blood pressure were dyslipidemia (06.87%) and obesity (13.7%). In clinical terms, hypertension was found in 75% of cases (n = 133) versus 25% (n = 44) of normotensive patients. These blood pressure profiles allowed us to classify our study population into two groups:<span "=""> hypertensives people and normotensives people. The hypertensives people had significantly higher mean pulsed pressure levels than the normotensives people. All normotensive patients had normal pulsed pressure. In the hypertensive population, the prevalence of high pulsed pressure was 31% (n = 41) versus 69% (n = 92) normal pulsed pressure. Concerning the relationship between 24 hour ambulatory pulsed pressure and left ventricular mass, hypertensives patients with a high ambulatory pulsed pressure had a significantly higher average indexed ventricular mass than the opposite groups (p = 0.039). Their ejection fraction was significantly lower than those of the opposite populations (p = 0.000). On the analysis of the correlation between the left ventricular mass and the tension profile, we noted in our series, a strong and significant correlation (r = 0.6342;p = 0.0000) between pulsed pressure and the ventricular geometry change. <b>Conclusion: </b>High ambulatory pulsed pressure remains an independent factor of change in left ventricular geometry in black people.</span> </div>展开更多
Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,e...Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older people.This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg to<130 mmHg(intensive treatment)or 130 mmHg to<150 mmHg(standard treatment).Patients underwent repeated examinations of the brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)at baseline,and the arterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this study.Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model.The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(P<0.001).Intensive treatment significantly delayed the progression of arterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,respectively.During a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment group.Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP<140 mmHg.Conclusion:Intensive blood pressure control with an SBP target of 110 mmHg to<130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration:http://www.clinicaltrials.gov;No.NCT03015311.展开更多
Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD....Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD. Doppler ultrasonographic measurement of ankle-brachial index (ABI) is the gold standard diagnosing method but requires training and is not necessarily available as an outpatient procedure. Using automated oscillometric blood pressure devices has been suggested as an easier method for measuring the ABI. Methods: A single observer palpated the arterial dorsalis pedis, examined hand joints and measured the ABI of one hundred diabetic patients using both Doppler and oscillometric methods. The purpose of this study was to compare the oscillometric method and the manual diagnosing methods to the gold standard method of using a hand held Doppler device for measuring the ABI and detecting PAD. Results: ABI was abnormal in 24 patients (24%) (22 males, 2 females) when measured with the Doppler method. Of these 24 patients, the oscillometric method would have missed 12 giving 12 false negatives. We found that the sensitivity of the oscillometric method was 50.0% and specificity 90.8%. Clinical examination with palpation of ADP combined with limited joint mobility (LJM) scoring would have missed only four cases. Conclusions: Although the oscillometric method is easy and accessible, it is not sensitive enough to be used as the only method in measuring ABI. The simple and inexpensive ADP pulse palpation combined with testing for LMJ was able to find 20 of the 24 (83%) patients with an abnormal ABI measured by Doppler stethoscope.展开更多
Background : Information obtained from arterial pulse waveforms (APW) can be usefulfor characterizing the cardiovascular system. To achieve this, it is necessary to know thedetailed characteristics of APWs in differen...Background : Information obtained from arterial pulse waveforms (APW) can be usefulfor characterizing the cardiovascular system. To achieve this, it is necessary to know thedetailed characteristics of APWs in different states of an organism, which would allowAPW parameters (APW- Ps) to be assigned to particular (patho)physiological conditions.Therefore, our work aimed to characterize 35 APW- Ps in rats under the influence ofisoflurane (ISO) and Zoletil/xylazine (ZO/XY) anesthesia and to study the effect of rootextract from Acanthopanax senticosus (ASRE) in these anesthetic conditions.Methods : The right jugular vein of anesthetized rats was cannulated for the administrationof ASRE and the left carotid artery for the detection of APWs from which 35APW- Ps were evaluated.Results : We obtained data on 35 APW- Ps, which significantly depended on the anesthesia,and thus, they characterized the cardiovascular system under these two conditions.ASRE transiently modulated all 35 APW- Ps, including a transient decrease insystolic and diastolic blood pressure (BP) and heart rate or increases in pulse BP, d P /d t max , and systolic and diastolic areas. Whereas the transient effects of ASRE weresimilar, the extract had prolonged disturbing effects on the cardiovascular system inrats under ZO/XY but not under ISO anesthesia. This negative effect can result fromthe disturbance caused by ZO/XY anesthesia on the cardiovascular system.Conclusions : We characterized 35 APW- Ps of rats under ISO and ZO/XY anesthesiaand found that ASRE contains compounds that can modulate the properties of thecardiovascular system, which significantly depended on the status of the cardiovascularsystem. This should be considered when using ASRE as a nutritional supplementby individuals with cardiovascular problems.展开更多
文摘Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.
文摘AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude(OPA). METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study. BMI (kg/m2) was calculated for every individual. IOP and OPA were measured with Pascal Dynamic contour tonometer (DCT). Blood pressure was also measured along with the DCT. The patients were divided into three groups according to BMI as: Group1, BMI<25; Group2, 25≤BMI<30; Group3, BMI≥30. Mean values of IOP, OPA, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used in statistical analysis.RESULTS: In Group1, the means of IOP, OPA, were 16.8±2.3mmHg, 2.7±0.7mmHg respectively; and SBP, DBP were 120.0±6.1mmHg, and 77.4±5.6mmHg respectively. In group2, the mean IOP, OPA, SBP, and DBP were found to be 16.6±2.1mmHg, 2.4±0.7mmHg, 121.7±5.3mmHg, and 79.5±4.9mmHg respectively. In group3, the mean IOP, OPA, SBP, and DBP were found to be 17.3±1.7mmHg, 2.1±0.7mmHg, 122.4±5.7mmHg, and 79.7±5.2mmHg respectively. There were no statistically significant difference between groups in terms of IOP, SBP and DBP, while OPA values were significantly lower in group3 (P=0.001). CONCLUSION: Decreased OPA values in individuals with higher BMI may indicate that subjects with higher BMI have lower choroidal perfusion and lower ocular blood flow.
文摘A slight reduction of blood pressure and heart rate can reduce the risk of developing cardiovascular disease. Maintenance of the respiratory rate within the normal range has also being identified as crucial for a healthy heart. Use of Indian and western music have been considered among many preventive programmes for long time in order to risk reduction associated with cardio vascular diseases. Therefore the aim of this study is to describe the effect of Indian classical music on systolic and diastolic blood pressure, pulse rate and respiratory rate in asymptomatic individuals aged 45 to 65 years. Methodology: A community based randomized intervention study was conducted in 252 asymptomatic individuals. The study group (n = 127) listened to a music based on Indian classical system (entire track of 22 minutes). The control group (n = 125) was kept silent for a similar time period. Systolic and diastolic blood pressure, pulse rate and respiratory rate of each study participant were monitored before and after the intervention. Results: Statistically significant reduction in systolic blood pressure (8.53 mmHg), diastolic blood pressure (5.8 mmHg), pulse rate (5.16 breaths per minute) and respiratory rate (2.55 per minute) were observed in the study group after listening to the music (p < 0.01). In the control group, changes observed during the period of intervention were not significant (p > 0.05). The reduction was independent of gender, age, education level, practicing a mind relaxation technique and preferred type of music of the participant. Conclusions: Listening to Indian classical music for about 22 minutes significantly reduced systolic and diastolic blood pressure, pulse rate and respiratory rate of asymptomatic individuals. Hence, music may have a potential benefit in cardio vascular disease preventive programmes.
文摘A noninvasive method for monitoring blood pressure, based on the principles established by Riva-Rocci and Korotkoff (K), is described;it furnishes, after a single compression-deflation cycle of the arm-encircling cuff, values of sys-tolic and diastolic blood pressures as well as the contours of the brachial arterial pulse and the corresponding volume pulse. K-sounds are detected by a single microphone situated in the cubital fossa, and the time-varying cuff pressure P(t) is read by a piezoresistive pressure sensor. The behavior of P(t) during deflation is resolved into two parts, P(t)=p(t)+b(t);p is a train of posi-tive going pulses (arising from arterial pulsa-tions), whereas b is a slowly changing baseline. Noise pulses in the microphone output are re-jected by using the observation that the first few K-sounds are emitted when p is close to a maxi-mum, and the last few when dp/dt is close to a maximum. The performance of the instrument is illustrated by showing how it copes with ambi-ent noise and involuntary manual perturbations of P, and by presenting contours of various pulses.
文摘Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest,during LBNP (10,20 and 30 mmHg,each for 15 min) and after NTG (10,30 and 100 μg/min,each dose for 15 min) in ten healthy volunteers. Cardiac pre-load,stroke volume and cardiac output were assessed by echocardiography. Central pressure augmentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results LBNP (20 mmHg) and NTG (30 μg/min) reduced pre-load (as measured by the peak velocity of the S wave in the superior vena cava) to a similar degree [by (26.8±3.8)% and (23.9±3.4)%,respectively]. Compared to LBNP,NTG reduced systemic vascular resistance [by (32.9±7.5)%,P<0.01],decreased peripheral and central pressure augmentation [by (20.8±3.4)% units and (12.9±2.9)% units,respectively,each P<0.01]. Conclusion These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.
文摘Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk of mortality. Aim: The aim was to identify the associations with absolute values of ΔSBP (|ΔSBP|) ≥10 mm Hg. Subjects and Methods: This study included 2481 patients. Patients with a body mass index ≥25 kg/m<sup>2</sup> were defined as obese. The group of A was defined as following: ankle-brachial index (ABI) was <0.9 or ≥1.3. ΔSBP was expressed as right arm BP minus left arm BP. |ΔSBP| ≥10 mm Hg were analyzed using multivariate logistic analysis. Results: |ΔSBP| ≥10 mm Hg was found in 6.0% of patients and |ΔSBP| < 5 mm Hg in 80.4%. In multivariate analysis, the odds ratios (ORs) of the associations with |ΔSBP| ≥10 mm Hg were significantly associated with abnormal ABI and obesity regardless of sex and age. Moreover, the OR of the combined effects of abnormal ABI and obesity was higher than that of abnormal ABI and obesity alone. Conclusion: |ΔSBP| ≥10 mm Hg was associated with abnormal ABI and obesity. In a primary care setting, blood pressure should be actively measured in both arms. This study suggests that the associations with |ΔSBP| ≥10 mm Hg may be a useful part of screening for abnormal ABI.
文摘Continuous non-invasive blood pressure (BP) measurement can be realized by using pulse transit time (PTT) based on electrocardiogram (ECG) and pulse wave signal. Modulated magnetic signature of blood (MMSB) is a promising approach to obtain PTT. The origin of MMSB is critical to establish the relationship between MMSB and BP. In this paper, two possible origins of MMSB, blood disturbance mechanism and angular variation mechanism, are analyzed and verified through three control experi-ments under different conditions. The influence of blood velocity alteration and blood volume alteration on magnetic field is investigated though blood flow simulation sys-tem. It is found that MMSB comes mainly from the periodic blood flow while the per-turbation caused by angular variation between sensitive axis of the magnetic sensor and geomagnetic field can be neglected. As to blood disturbance mechanism, the change of blood volume plays a decisive role while the effect of blood velocity altera-tion is negligible.
基金Supported by Science and Technology Commission of Shanghai(074119644,09DZ2272100)Shanghai Leading Academic Discipline Project(S30206)
文摘Objective To compare the effect of chemomechanical caries removal (CMCR) to traditional drilling (TD) on blood pressure and pulse in children. Methods Of all 105 subjects, 53 were randomly assigned to CMCR group; 52, to TD group. For each subject, the systolic pressure (SP), diastolic pressure (DP) and pulse ( P ) were measured at five time-point: pre-treatment, initiation of carious removal, the end of carious removal, the end of the cavity restoration, and the end of the dental care. They were recorded as To, T1 , T2, T3, and TE, respectively. The difference of SP, DP, and P within each group were analyzed. Results Of all 105 subjects, 14 were administered local anesthesia. Since local anesthesia may be a confounding factor for changes in blood pressure and pulse, only the data of the other 91 subjects that local anesthesia were not administered were analyzed. Regarding the SP, DP, and P for TD, the difference between TO and T1 was significant ( P = 0. 013, 0. 015, 0. 012 respectively), while not significant between T1 and T2, T2 and T3, T3 and TE( P 〉0. 05). Regarding the SP, DP, and P for CMCR, the differences were not significant between every two consecutive time-points ( P 〉 0. 05). The differences of the SP, DP, and P between CMCR and TD were not significant for time-points T0, T3 and Te (p 〉 0. 05 ), while significant for T1 and T2 ( P 〈 0. 05 ). Conclusion In general, CMCR induces less increase of blood pressure and pulse in children compared to traditional drilling (TD). It may be inferred that CMCR is less distressing than TD.
基金Supported by Research project PRVOUK P37-08(from Charles University in Praha,Faculty of Medicine at Hradec Kralove,Czech Republic)
文摘To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m<sup>2</sup> in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.
基金supported by the Young Scholar Scientific Research Foundation of the Chinese Center for Disease Control and Prevention(grant#China CDC 2010A205)
文摘Objective To estimate the prevalence of elevated blood pressure(EBP) in Chinese children and identify individual and family factors associated with EBP. Methods A nationwide cross-sectional study was conducted in 2010 using stratified cluster sampling. Participants' blood pressure was measured, and their parents completed a questionnaire on personal and family characteristics. Prevalence and correlates of EBP were assessed. Results Among a total of 24,333 participants, 20.2% of boys and 16.3% of girls had EBP. The prevalence of EBP increased with the ascending trend of waist circumference, Waist-to-height ratio, and body mass index. The adjusted prevalence ratios(aP Rs) for obese boys and girls were 2.50 and 2.97, respectively. Fewer urban boys(16.2%) had EBP than rural boys(21.7%). Boys with a family history of hypertension were 12% more likely to have EBP. Children whose mothers received a college education tended to have lower likelihood of EBP; with an aP R was 0.85 among boys and 0.78 among girls. Conclusion EBP is common among obese students and those who have a family history of hypertension. A negative association between mothers' education levels and EBP risk in children was found.
文摘The importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), on the incidence of coronary heart disease (CHD) and stroke are known. However, the importance of blood pressure (BP)-age shifts regarding the stroke incidence is not clearly known. The BP changes with the advancement of age from the predominance of DBP in the young to the predominance of SBP in the old. This change is due to the stiffening of the large arteries as a result of the aging process and the replacement of the elastic fibers with collagen fibers. This change results in the loss of compliance and the elastic recoil of these vessels leading to increase in pulse wave velocity, central SBP and widening of pulse pressure leading to an increased incidence of CHD and strokes. It has been demonstrated epidemiologically that the SBP rises linearly with age, whereas the DBP rises up to the age of 45-50 years, and then begins to decline after the age of 60 years leading to a progressive widening of PP. Several studies have shown an inverse relationship between DBP and CHD, whereas no such relationship has been demonstrated for stroke. However, a recent study showed an inverse relationship with DBP and stroke when it dropped below 71 mmHg in subjects 50 years of age or older. In contrast, there was a positive association between BP and stroke when both SBP and DBP were ≥ 71 mmHg. These findings suggest that intreating systolic hypertension in the elderly to reduce stroke risk, attention should be paid on the potential harm of low DBP and the widening of PP regarding CHD and stroke. The implications of BP shifts with age and the potential risks of low DBP regarding the risk of stroke will be discussed in this concise review.
文摘Because of the paucity of serial blood pressure data on the same individuals, little is known about the accuracy of elevated blood pressure (BP) in childhood for predicting hypertension (HBP) later in life. The availability of long-term serial BP data from the Fels Longitudinal Study (FLS) presents the opportunity to link HBP in adulthood directly to BP measured decades earlier in the same individuals as children. We analyzed serial data from 965 men and 1114 women in the FLS. We used an autoregressive-moving average (1, 1) [ARMA (1, 1)] longitudinal model to predict adult HBP from childhood values. For 15-year-old boys with SBP 15 mmHg and 30 mmHg above the average SBP of 90 mmHg, the probabilities of having HBP at age 35 are 0.18 and 0.33, respectively. The corresponding probabilities for 15-year-old girls are only 0.04 and 0.08. This striking sex difference in risk of HBP at age 35 between 15-year-old boys and girls indicates that the risk of developing HBP in women is low regardless of their childhood blood pressure at any age from 2 to 17 years. Men are about 4.25 times more likely to have HBP at age 35 than women over a range of SBP of 90 - 140 mmHg at age 15. The ARMA (1, 1) model allows the identification of boys at risk for HBP as adult men.
文摘The principle for blood pressure measurement using pulse transit time is introduced in this paper.And the math model of synergetics theory is studied in detail.The synergetics theory is applied in the analysis of blood pressure measurement data.The simulation results show that the application of synergetics theory is helpful to judge the normal blood pressure,and the accuracy is up to 80%.
文摘In recent years, the demand for almond milk and its sales has increased owing to consumers’ perceptions about its health benefits. Hence, we sought to measure the effect of almond milk on body measurements such as body weight, body mass index and waist and hip circumference, in addition to diastolic and systolic blood pressures. Thirty volunteers of both sexes participated in the study, with a mean age of 23.27 ± 6.20 years. The study was conducted over 4 weeks, and the results showed that daily substitution of one serving of dairy product with one cup (240 ML) of almond milk significantly decreased body weight, body mass index and waist and hip circumference, However, no effects were observed on blood pressures.
文摘Continuous measurement of blood pressure based on pulse transit time (PTT) using GMR sensors is the state-of-art non-invasive cuffless method in which modulated magnetic signature of blood (MMSB) is used. In this paper, the mechanism of MMSB is investigated. According to the experimental results, it is found that both blood pulse flowing through the applied magnetic field and the displacement of the GMR sensor caused by blood pulse contribute to the disturbance of magnetic field detected by GMR sensors. The feasibility of MMSB method is discussed as well.
基金The work of this paper is supported by the National Natural Science Foundation of China under Grant No.61572038,the Innovation Project Foundation NCUT.
文摘Blood pressure is an important physiological parameter to reflect human vital signs.In order to achieve the non-contact dynamic blood pressure acquisition based on ordinary optical camera,a theoretical understanding of the functional relationship between blood pressure and pulse wave signal conduction time.And through imaging photoelectric plethysmography(IPPG),pulse wave signal conduction time of forehead and hand was obtained with ordinary optical camera.First,the pulse wave conduction time was obtained by recording the video with an ordinary optical camera.Second,real-time blood pressure values were collected.Finally,based on the relationship between blood pressure and pulse wave conduction time,a non-contact blood pressure measurement prediction model was obtained through neural network fitting.So that non-contact blood pressure measurement with optical camera could be completed.The method in this paper has several advantages,such as low requirements on measuring equipment,low cost,and simple operation.It can let people get rid of the discomfort caused by measuring equipment such as cuff and can measure blood pressure at any time.The predicted blood pressure results were compared with an Omron wrist electronic sphygmomanometer.The calculated error of systolic blood pressure is-9.28%~3.16%,and the error of diastolic blood pressure is-9.84~4.35%.
文摘<div style="text-align:justify;"> <strong>Introduction-Purpose: </strong><span "="">Pulsed pressure is recognized as an important predictor of cardiovascular risk. The purpose of this study was to identify a possible association between high ambulatory pulsed pressure and left ventricular geometry change in African black people. <b>Material and methods:</b> We conducted a bicentric, retrospective descriptive and analytical study that took place from 2010 to 2015 at the Abidjan Heart Institute and the Polyclinic Sainte Anne Marie in Abidjan. The people were selected from MAPA’s archive files. Those aged 18 years and over were included, all of whom had valid echocardiography and MAPA. The analyzed parameters concerned epidemiological data with age, gender and body surface area. The clinical data analyzed included systolic, diastolic, mean and 24-hours pulsed pressures. On the echocardiographic parameters, it was the evaluation of the ventricular mass indexed to the body surface. <b>Results: </b>A total of 177</span> patients records were selected. The mean age of the patients was 56.32 ± 10.51 years. There was a male predominance with a sex ratio of 1.15. The main cardiovascular risk factors found outside high blood pressure were dyslipidemia (06.87%) and obesity (13.7%). In clinical terms, hypertension was found in 75% of cases (n = 133) versus 25% (n = 44) of normotensive patients. These blood pressure profiles allowed us to classify our study population into two groups:<span "=""> hypertensives people and normotensives people. The hypertensives people had significantly higher mean pulsed pressure levels than the normotensives people. All normotensive patients had normal pulsed pressure. In the hypertensive population, the prevalence of high pulsed pressure was 31% (n = 41) versus 69% (n = 92) normal pulsed pressure. Concerning the relationship between 24 hour ambulatory pulsed pressure and left ventricular mass, hypertensives patients with a high ambulatory pulsed pressure had a significantly higher average indexed ventricular mass than the opposite groups (p = 0.039). Their ejection fraction was significantly lower than those of the opposite populations (p = 0.000). On the analysis of the correlation between the left ventricular mass and the tension profile, we noted in our series, a strong and significant correlation (r = 0.6342;p = 0.0000) between pulsed pressure and the ventricular geometry change. <b>Conclusion: </b>High ambulatory pulsed pressure remains an independent factor of change in left ventricular geometry in black people.</span> </div>
基金supported by grants from the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Nos.2016-I2M-1-006 and 2021-I2M-1-011)
文摘Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older people.This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg to<130 mmHg(intensive treatment)or 130 mmHg to<150 mmHg(standard treatment).Patients underwent repeated examinations of the brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)at baseline,and the arterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this study.Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model.The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(P<0.001).Intensive treatment significantly delayed the progression of arterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,respectively.During a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment group.Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP<140 mmHg.Conclusion:Intensive blood pressure control with an SBP target of 110 mmHg to<130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration:http://www.clinicaltrials.gov;No.NCT03015311.
文摘Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD. Doppler ultrasonographic measurement of ankle-brachial index (ABI) is the gold standard diagnosing method but requires training and is not necessarily available as an outpatient procedure. Using automated oscillometric blood pressure devices has been suggested as an easier method for measuring the ABI. Methods: A single observer palpated the arterial dorsalis pedis, examined hand joints and measured the ABI of one hundred diabetic patients using both Doppler and oscillometric methods. The purpose of this study was to compare the oscillometric method and the manual diagnosing methods to the gold standard method of using a hand held Doppler device for measuring the ABI and detecting PAD. Results: ABI was abnormal in 24 patients (24%) (22 males, 2 females) when measured with the Doppler method. Of these 24 patients, the oscillometric method would have missed 12 giving 12 false negatives. We found that the sensitivity of the oscillometric method was 50.0% and specificity 90.8%. Clinical examination with palpation of ADP combined with limited joint mobility (LJM) scoring would have missed only four cases. Conclusions: Although the oscillometric method is easy and accessible, it is not sensitive enough to be used as the only method in measuring ABI. The simple and inexpensive ADP pulse palpation combined with testing for LMJ was able to find 20 of the 24 (83%) patients with an abnormal ABI measured by Doppler stethoscope.
基金Agency of the Slovak Republic,Grant/Award Number:2/0023/22,2/0066/23 and 2/0091/21Slovak Research&Development Agency,Grant/Award Number:APVV-19-0154 and APVV-22-0154。
文摘Background : Information obtained from arterial pulse waveforms (APW) can be usefulfor characterizing the cardiovascular system. To achieve this, it is necessary to know thedetailed characteristics of APWs in different states of an organism, which would allowAPW parameters (APW- Ps) to be assigned to particular (patho)physiological conditions.Therefore, our work aimed to characterize 35 APW- Ps in rats under the influence ofisoflurane (ISO) and Zoletil/xylazine (ZO/XY) anesthesia and to study the effect of rootextract from Acanthopanax senticosus (ASRE) in these anesthetic conditions.Methods : The right jugular vein of anesthetized rats was cannulated for the administrationof ASRE and the left carotid artery for the detection of APWs from which 35APW- Ps were evaluated.Results : We obtained data on 35 APW- Ps, which significantly depended on the anesthesia,and thus, they characterized the cardiovascular system under these two conditions.ASRE transiently modulated all 35 APW- Ps, including a transient decrease insystolic and diastolic blood pressure (BP) and heart rate or increases in pulse BP, d P /d t max , and systolic and diastolic areas. Whereas the transient effects of ASRE weresimilar, the extract had prolonged disturbing effects on the cardiovascular system inrats under ZO/XY but not under ISO anesthesia. This negative effect can result fromthe disturbance caused by ZO/XY anesthesia on the cardiovascular system.Conclusions : We characterized 35 APW- Ps of rats under ISO and ZO/XY anesthesiaand found that ASRE contains compounds that can modulate the properties of thecardiovascular system, which significantly depended on the status of the cardiovascularsystem. This should be considered when using ASRE as a nutritional supplementby individuals with cardiovascular problems.