The effectiveness of physical activity interventions on blood pressure in children and adolescents:A systematic review and network meta-analysis

Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.

Blood Pressure Estimation with Phonocardiogram on CNN-Based Approach

Monitoring blood pressure is a critical aspect of safeguarding an individual’s health,as early detection of abnormal blood pressure levels facilitates timely medical intervention,ultimately leading to a reduction in mortality rates associated with cardiovascular diseases.Consequently,the development of a robust and continuous blood pressure monitoring system holds paramount significance.In the context of this research paper,we introduce an innovative deep learning regression model that harnesses phonocardiogram(PCG)data to achieve precise blood pressure estimation.Our novel approach incorporates a convolutional neural network(CNN)-based regression model,which not only enhances its adaptability to spatial variations but also empowers it to capture intricate patterns within the PCG signals.These advancements contribute significantly to the overall accuracy of blood pressure estimation.To substantiate the effectiveness of our proposed method,we meticulously gathered PCG signal data from 78 volunteers,adhering to the ethical guidelines of Suranaree University of Technology(Human Research Ethics number EC-65-78).Subsequently,we rigorously preprocessed the dataset to ensure its integrity.We further employed a K-fold cross-validation procedure for data division and alignment,combining the resulting datasets with a CNNfor blood pressure estimation.The experimental results are highly promising,yielding aMeanAbsolute Error(MAE)and standard deviation(STD)of approximately 10.69±7.23 mmHg for systolic pressure and 6.89±5.22 mmHg for diastolic pressure.Our study underscores the potential for precise blood pressure estimation,particularly using PCG signals,paving the way for a practical,non-invasive method with broad applicability in the healthcare domain.Early detection of abnormal blood pressure levels can facilitate timely medical interventions,ultimately reducing cardiovascular disease-related mortality rates.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.

Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

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.

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

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.

Mediating function of heart failure in the causal relationship between diastolic blood pressure and hypertensive renal disease with renal failure:a mediated Mendelian randomization study

Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by network Mendelian randomization(MR).Methods:Genome-wide analysis of DBP,HRDRF,and HF was downloaded from the public database(Genome-Wide Analysis Study[GWAS])and was used to analyze the results and to conduct mediated MR analysis.Results:Analysis showed that DBP was positively correlated with HRDRF(OR=1.0002,95%CI:1.0001–1.0003,P=1.8076e-05)and DBP was positively correlated with HF(OR=1.0295,95%CI:1.0221–1.0370,P=2.5292e-15).HF and HRDRF had a positive causal effect(OR=1.0001,95%CI:1.0000–1.0001,P=0.0152).Mediation analysis showed that the contribution ratio of HF to the combined effect of DBP and HRDRF was 24.69%.Conclusions:DBP can increase the risk of renal disease with renal failure,and HF may play an impor tant role in mediating this causal relationship.

Acute Effects of Virtual Reality Exercise on Young Adults’ Blood Pressure and Feelings

Virtual reality(VR)seems to have the potential to provide opportunities to promote physical activity(PA)in a fun way.This paper aimed to examine the acute effects of three different virtual reality-based exercise bikes on young adults’blood pressure(BP)and feelings compared to a traditional exercise cycling session.Four exercise sessions(immersive VR cycling,two non-immersive VR cycling,and traditional cycling)were completed by 36 young adults(22 females;Mage=23.6 years).BP was measured immediately before and after each session using a BP cuff and exercise-induced feelings were assessed via an established survey immediately after each session.Parti-cipants’previous experience with VR was used as the covariate in the ANCOVA with repeated measures.Signif-icant main effects were observed across cycling sessions for systolic blood pressure[F(2,29)=3.04,p=0.02,(η^(2)=0.38)]and feelings[F(3,32)=7.74,p<0.01,η^(2)=.42].In particular,immersive VR and traditional cycling signif-icantly increased systolic blood pressure compared to the two non-immersive VR sessions.Moreover,immersive VR significantly increased feelings compared to the two non-immersive VR sessions,whereas these two non-immersive VR exercises had significantly greater increased feelings compared to traditional cycling,respectively.Findings suggest immersive VR-based exercise cycling may lead to higher exercise intensities compared to non-immersive VR cycling.Further,immersive VR cycling yielded higher feelings compared to non-immersive VR and traditional cycling.Thus,immersive VR-based exercise can be a fun and physically active health promotion tool among young adults.

Ambient Fine Particulate Matter Exposure and Blood Pressure:Evidence from a Large Chinese Multiple Follow-Up Study

Objective This study aimed to investigate the association of ambient PM_(2.5)exposure with blood pressure(BP)at the population level in China.Methods A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011–2015.Their long-term PM_(2.5)exposure was assessed at the geographical level,on the basis of a regular 0.1°×0.1°grid over China.A mixed-effects regression model was used to assess associations.Results Each decrease of 10μg/m^(3)in the 1 year-mean PM_(2.5)concentration(FPM1Y)was associated with a decrease of 1.24[95%confidence interval(CI):0.84–1.64]mmHg systolic BP(SBP)and 0.50(95%CI:0.25–0.75)mmHg diastolic BP(DBP),respectively.A robust association was observed between the long-term decrease in PM_(2.5)and decreased BP in the middle-aged and older population.Using a generalized additive mixed model,we further found that SBP increased nonlinearly overall with FPM1Y but in an approximately linear range when the FPM1Y concentration was<70μg/m^(3);In contrast,DBP increased approximately linearly without a clear threshold.Conclusion Efficient control of PM_(2.5)air pollution may promote vascular health in China.Our study provides robust scientific support for making the related air pollution control policies.

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.

Analysis of the relationship between 24-hour sodium and blood pressure and the dietary status based on mobile phone APP in the high-risk population of hypertension in Haikou

Objective:To understand the dietary intake of high-risk population with hypertension in Haikou,and to analyze the relationship between dietary intake and blood pressure,especially the relationship between sodium intake and blood pressure,so as to provide a scientific basis for salt reduction.Methods:A multi-stage cluster sampling 2021 was used from July to December to collect 3-4 cscs from each of the four districts in Haikou.A total of 15 cscs were collected,295 permanent residents aged 55-74 were recruited from 15 community service centers,with 20 eligible subjects from each community.The subjects underwent general physical examination,laboratory tests,and a dietary survey using the self-developed Android phone APP“Nutrition Assistant”(registration number:2021SR1547832).SPSS 21.0 was used 2 for t test,x^(2) test and multiple Regression analysis.Result:In Haikou,69.4%of the subjects had energy intake above energy requirement,and 44.8%had fat intake above the acceptable range of macronutrients.There were only differences in energy,carbohydrate,vitamin B 6 and sodium intake(t=-2.174,-1.990,2.333,-5.442,P=0.031,0.048,0.021,<0.001,respectively).There were significant differences in BMI,family history of chronic diseases,systolic blood 2 pressure and diastolic blood pressure(f value or x^(2) value were 4.260,19.045,139.916,36.864,P value were 0.015,<0.001,<0.001,<0.001,respectively).Multiple Regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure(t=12.964,P<0.001),systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg,respectively.Conclusion:The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced,and the intake of sodium salt was strongly correlated with blood pressure,it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension.

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.

Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults

BACKGROUND Blood pressure variability(BPV)has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies.However,the relationship between BPV and subtle cognitive decline(SCD)has received minimal attention in this field of research to date and has rarely been reported.AIM To examine whether SCD is independently associated with changes in BPV in older adults.METHODS Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022.The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group.The basic data,laboratory examinations,scale tests,and ambulatory blood pressure test results of the two groups were analyzed retrospectively,and the relationship between SCD and BPV was subsequently evaluated.RESULTS Significant differences were observed between the two groups of participants(P<0.05)in terms of age,education level,prevalence rate of diabetes,fasting blood glucose level,24-h systolic blood pressure standard deviation and coefficient of variation,24-h diastolic blood pressure standard deviation and coefficient of variation.The scale monitoring results showed significant differences in the scores for memory,attention,and visual space between the experimental and control groups.Logistic regression analysis indicated that age,education level,blood sugar level,and BPV were factors influencing cognitive decline.Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD,even after adjusting for related factors.Each of the above differences was still significant.CONCLUSION This study suggests that increased BPV is associated with SCD.

Effect of Salvia Miltiorrhiza Injection on Blood Pressure and Cardiac Function in Rats with Gestational Hypertension and Preeclampsia

Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.

Clinical and Therapeutic Evaluation of Hypertensives According to the Practice of Ambulatory Blood Pressure Measurement (ABPM) at the Bel Air International Clinic in Conakry from January 1, 2019 to November 30, 2022

Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2 = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.

Effects of Continuous Non-Invasive Blood Pressure Monitoring on Intraoperative Hemodynamics and Postoperative Myocardial Injury in Craniotomy:Comparison Between Groups Based on Self-Control and Propensity Score Matching

Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.

The use of health coaching in controlling blood pressure of hypertensive patients in the family:literature review

Background:Family is an essential element in caring for clients with hypertension.Appropriate hypertension management can reduce health risks during the treatment.Health coaching in family is a critical intervention to control and manage hypertension through providing education,information,and skills intervention are needed to support lifestyle improvements,manage chronic conditions,and prevent complications of hypertension.This literature study describes health coaching for controlling blood pressure among clients with hypertension in the family.Methods:Narrative literature review was performed to select the article that relates to health coaching of hypertension in the family using search engines including PubMed,ProQuest,SpringerLink,ScienceDirect,and Google Scholar by using keywords health coaching,family,hypertension,and blood pressure.The analysis of articles was carried out using four stages based on the PRISMA flowchart diagram.Results:The results indicated eight articles that were analyzed in this study.Interactive health coaching interventions based on a healthy lifestyle carried out with patients and families effectively improve medication adherence and reduce systolic and diastolic blood pressure.Meanwhile,health coaching applied regarding the principles including motivation,discussion,interviews and goal setting to influence behavior change and self-management.Conclusions:That health coaching applied for families with clients with hypertension is effect on reducing blood pressure and other changes,including knowledge,self-efficacy,and behavior towards health services for patients with hypertension.Therefore,health coaching for the family could be used as a family intervention for clients with hypertension during home health care.

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.

Blood Pressure and Heart Rate Measurements Using Photoplethysmography with Modified LRCN

In this study,single-channel photoplethysmography(PPG)signals were used to estimate the heart rate(HR),diastolic blood pressure(DBP),and systolic blood pressure(SBP).A deep learning model was proposed using a long-term recurrent convolutional network(LRCN)modified from a deep learning algorithm,the convolutional neural network model of the modified inception deep learning module,and a long short-term memory network(LSTM)to improve the model’s accuracy of BP and HR measurements.The PPG data of 1,551 patients were obtained from the University of California Irvine Machine Learning Repository.How to design a filter of PPG signals and how to choose the loss functions for deep learning model were also discussed in the study.Finally,the stability of the proposed model was tested using a 10-fold cross-validation,with an MAE±SD of 2.942±5.076 mmHg for SBP,1.747±3.042 mmHg for DBP,and 1.137±2.463 bpm for the HR.Compared with its existing counterparts,the model entailed less computational load and was more accurate in estimating SBP,DBP,and HR.These results established the validity of the model.