INTRODUCTION

Hypertension is a serious public health issue that puts individuals at risk for various morbidity and mortality indicators. One of the most crucial factors in managing blood pressure and preventing complications is medication adherence which is linked to several determinants. This study explored the correlation between medication adherence among middle-aged hypertensive adults and the different domains of quality of life (QOL), which includes physical, psychological, social relationship and environment.

METHODS

This cross-sectional study involved 96 Filipino residents of Brgy. San Jose, Navotas City aged 35 to 65 years old diagnosed with hypertension and prescribed anti-hypertensive medications. Pearson’s correlation coefficient was used to calculate the correlation between different domains of QOL as well as the overall QOL score.

RESULTS

Results revealed a statistically significant but weak positive correlation between overall QOL and medication adherence (r = 0.336, p<0.001). Among the QOL domains, environmental domain had the strongest correlation with adherence (r = 0.446, p = 0.00), followed by physical health (r = 0.443, p = 0.01) and psychological well-being (r = 0.382, p = 0.01). The social relationship domain showed negligible correlation (r = 0.163, p = 0.4).

CONCLUSION

The study demonstrates that while medication adherence is modestly associated with better perceived QOL, especially in physical, psychological and environmental aspects, other factors likely influence both outcomes. These findings highlight the need for holistic, community-based interventions that address not only medication adherence but also environmental and psychosocial barriers to care in managing hypertension.

Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Quality Of Life ; Public Health ; Medication Adherence ; Antihypertensive Agents ; Blood Pressure ; Interpersonal Relations

Introduction: Hypertension is common in obesity and increases cardiovascular risk. Bariatric surgery improves metabolic health, but subgroup differences in blood pressure response remain unclear. This study examined 1-year changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after bariatric surgery across sex, age group, and diabetes status. Methodology: This study included 32 obese adults undergoing bariatric surgery, with blood pressure measured at baseline, 6 and 12 months. Generalized estimating equation models were used to evaluate changes in SBP and DBP over time, adjusting for age, sex, surgery type, diabetes category, baseline body mass index, antihypertensive medication use, and baseline blood pressure. Interaction terms were tested to assess differences in blood pressure trajectories across subgroups. Results: Participants were predominantly female (67.4%), with a mean age of 36.9 ± 6.2 years and a mean body mass index of 40.7 ± 8.8 kg/m². Hypertension and diabetes were present in 40.6 and 31.3% of participants, respectively. There was a significant time effect for both SBP (p <0.001) and DBP (p = 0.004). At 12 months post-surgery, mean SBP decreased by 15 mmHg and DBP by 7.9 mmHg compared with baseline (both p <0.001). No significant interactions were observed between time and sex, diabetes category, or age category, indicating that blood pressure improvements were comparable across subgroups. Conclusion Bariatric surgery was associated with clinically meaningful reductions in both SBP and DBP, with similar improvement patterns observed across demographic and metabolic subgroups. These findings support the effectiveness of bariatric surgery as a strategy for blood pressure reduction and cardiovascular risk management in patients with obesity.
Blood Pressure ; Bariatric Surgery

OBJECTIVE: To observe the effects of Yisui Yangxin moxibustion (moxibustion for benefiting the marrow and nourishing the heart) in sequential trial on blood pressure (BP), perimenopausal symptoms, cardiovascular function and heart rate variability (HRV) in prehypertension in perimenopausal women. METHODS: The eligible female patients of prehypertension of perimenopausal period were collected according to the inclusion criteria. Based on the requirements of open two-way qualitative response sequential trial, the sample size was not set in advance, and the matched pair design was used for random division into a moxibustion group and a health education group. The patients of the two groups were treated in pairs, and the analysis was immediately performed after the end of treatment for each pair, and the sequential trial analysis (STA) was diagrammed. The health education group provided the health education for prehypertension to the patients according to 2018 Revised Chinese Hypertension Prevention and Treatment Guidelines. In the moxibustion group, beside the health education for prehypertension, the non-suppurative moxibustion was delivered at Baihui (GV20), Guanyuan (CV4) and bilateral Neiguan (PC6) and Zusanli (ST36), once every two days, 3 treatments per week and for 4 consecutive weeks. Before treatment, in 2 and 4 weeks of treatment, as well as in 1-month follow-up after treatment, BP was measured in each group, separately. Before treatment and in 4 weeks of treatment, the observation was performed in the score of the modified Kupperman scale, and Pittsburgh sleep quality index (PSQI) score, the indexes of cardiovascular function (stroke volume [SV], cardiac output per minute [CO], stroke index [SI], cardiac index [CI], left ventricular effective pumping force [VPE], left ventricular energy efficiency [EWK], arterial compliance [AC], left ventricular ejection resistance [VER], blood viscosity (N), and microcirculation half update rate [MHR]), and heart rate variability (HRV) indexes (low frequency [LF], high frequency [HF], LF/HF, standard deviation of NN interval [SDNN], root mean square of successive differences in adjacent NN intervals [RMSSD]). RESULTS: Based on sequential test line, when the trial was performed to the 17th pair, and the test line touched the upper limit U, meaning the results of the moxibustion group was superior to the health education group, thus, the trial stopped immediately. In 2 and 4 weeks of treatment and in follow-up, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower when compared with those before treatment in the moxibustion group (P<0.05); SBP at each time point and DBP in 2 and 4 weeks of treatment in the moxibustion group were lower than those of the health education group (P<0.05). After treatment, the score of the modified Kupperman scale was reduced when compared with that before treatment in the moxibustion group (P<0.05). The score of the modified Kupperman scale and PSQI in the moxibustion group were lower than those of the health education group after treatment (P<0.05). After treatment, SV, CO, SI, CI and EWK were increased in comparison with the indexes before treatment in the moxibustion group (P<0.05), and VER and N were dropped (P<0.05). After treatment, SV, CO, SI, CI and EWK in the moxibustion group were higher than those of the health education group (P<0.05), and VER and N were lower (P<0.05). After treatment, in the moxibustion group, LF, HF, SDNN and RMSSD were increased in comparison with those before treatment (P<0.05), and LF/HF was declined (P<0.05). In the health education group, after treatment, LF, HF, SDNN and RMSSD decreased when compared with those before treatment (P<0.05). After treatment, LF, HF, SDNN and RMSSD in the moxibustion group were higher than those of the health education group (P<0.05), and LF/HF was lower (P<0.05). The total effective rate was 94.1% (16/17) in the moxibustion group, higher than that (41.2%, 7/17) in the health education group (P<0.05). CONCLUSION Moxibustion can reduce SBP and DBP in prehypertension of perimenopausal women, alleviate perimenopausal symptoms, improve cardiac function and adjust the overall balance of cardiac autonomic nerves.
Humans ; Female ; Middle Aged ; Moxibustion ; Perimenopause ; Blood Pressure ; Prehypertension/prevention & control* ; Heart Rate ; Acupuncture Points ; Adult

OBJECTIVE: To compare the clinical efficacy of acupuncture with Neiguan (PC6)-to-Waiguan (TE5) and esmolol on hemodynamics during anesthesia induction and postoperative nausea and vomiting. METHODS: A total of 100 patients undergoing elective laparoscopic hernia repair or gynecological surgery under general anesthesia were randomly divided into an acupuncture group (50 cases, 3 cases were eliminated) and an esmolol group (50 cases, 2 cases were eliminated). In the acupuncture group, before anesthesia induction, patients were applied to acupuncture with Neiguan (PC6)-to-Waiguan (TE5), and the needles were retained for 15 min on the right side and 30 min on the left side. Patients in the esmolol group were intravenously injected with 20 mg esmolol hydrochloride injection 5 min before anesthesia induction. The systolic blood pressure (SBP) and heart rate (HR) of the two groups were recorded at 5 min after entering the operating room (T₀), before anesthesia induction (T₁), after anesthesia induction (T₂), before tracheal intubation (T₃) and 1 min after tracheal intubation (T₄). The visual analogue scale (VAS) scores of pain and the incidence of nausea and vomiting in the two groups were observed at the time of entering postanesthesia care unit (PACU) (T₅), leaving PACU (T₆), 6 h after operation (T₇) and 24 h after operation (T₈). The dosage of anesthesia-related drugs in the two groups was counted. RESULTS: The SBP and HR of the two groups at T₂, T₃ and T₄ were lower than those at T₁ (P<0.05). SBP and HR at T₃ in the acupuncture group were higher than those in the esmolol group (P<0.05). Compared with the esmolol group, in the acupuncture group, the VAS scores of pain at T₆ and T₇ were decreased (P<0.05), the incidence of nausea and vomiting at T₇ and T₈ and the nausea and vomiting visual analogue scale (NVAS) scores were decreased (P<0.05). Compared with the esmolol group, the dosage of propofol in the acupuncture group was decreased (P<0.05). CONCLUSION Acupuncture with Neiguan (PC6)-to-Waiguan (TE5) can relieve hemodynamic fluctuations during anesthesia induction, reduce postoperative pain and nausea and vomiting, and reduce the dosage of propofol. The curative effect is better than that of esmolol.
Humans ; Female ; Adult ; Middle Aged ; Acupuncture Points ; Male ; Hemodynamics ; Propanolamines/administration & dosage* ; Postoperative Nausea and Vomiting/drug therapy* ; Young Adult ; Heart Rate ; Aged ; Blood Pressure ; Acupuncture Therapy

OBJECTIVE: To observe the clinical efficacy of acupoint magnetotherapy as an adjunctive treatment for mild to moderate hypertension with yin deficiency and yang hyperactivity. METHODS: A total of 66 patients with mild to moderate hypertension of yin deficiency and yang hyperactivity were randomly divided into a magnetotherapy group (33 cases, 3 cases dropped out) and a non-magnetotherapy group (33 cases, 4 cases dropped out). Both groups were given antihypertensive drugs based on their clinical conditions. The magnetotherapy group and the non-magnetotherapy group wore surface magnetic therapy bands with or without magnetic poles, respectively, at unilateral Neiguan (PC6) and Waiguan (TE5). Intervention was administered once daily, 8 h each time, for a continuous period of 4 weeks. Traditional Chinese Medicine (TCM) syndrome score, Du's hypertension quality of life (QOL) scale score, office blood pressure, and 24-hour ambulatory blood pressure were assessed before and after the intervention, and the clinical efficacy was evaluated after intervention. RESULTS: After the intervention, both groups showed reductions in TCM syndrome scores, office systolic blood pressure (SBP), and diastolic blood pressure (DBP) compared with those before intervention (P<0.001), and their Du's QOL scores increased (P<0.001). The magnetotherapy group had lower TCM syndrome score and office SBP and DBP than those in the non-magnetotherapy group (P<0.001), while Du's QOL score was higher (P<0.001). After the intervention, all 24-hour ambulatory blood pressure indexes in the magnetotherapy group were reduced compared with those before intervention (P<0.05); in the non-magnetotherapy group, 24-hour average diastolic blood pressure (24hDBP), nighttime average systolic blood pressure (nSBP), and nighttime average diastolic blood pressure (nDBP) were reduced (P<0.05). The 24-hour average systolic blood pressure (24hSBP), 24hDBP, daytime average systolic blood pressure (dSBP), daytime average diastolic blood pressure (dDBP), and nSBP after intervention in the magnetotherapy group were lower than those in the non-magnetotherapy group (P<0.05). The total effective rate in the magnetotherapy group was 93.3% (28/30), which was higher than 75.9% (22/29) in the non-magnetotherapy group (P<0.05). CONCLUSION Acupoint magnetotherapy as an adjunctive treatment for mild to moderate hypertension with yin deficiency and yang hyperactivity could effectively alleviate clinical symptoms and TCM syndromes, improve quality of life, and reduce blood pressure level.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Points ; Hypertension/physiopathology* ; Adult ; Yin Deficiency/physiopathology* ; Aged ; Blood Pressure ; Magnetic Field Therapy ; Acupuncture Therapy ; Treatment Outcome ; Combined Modality Therapy

The nucleus tractus solitarius (NTS) is the primary brain region for receiving and integrating cardiovascular afferent signals. It plays a crucial role in maintaining balance of autonomic nervous system and regulating blood pressure through cardiovascular reflexes. Neurons within the NTS form complex synaptic connections and interact reciprocally with other brain regions. The NTS regulates autonomic nervous system activity and arterial blood pressure through modulating baroreflex, sympathetic nerve activity, renin-angiotensin-aldosterone system, and oxidative stress. Dysfunctions in NTS activity may contribute to hypertension. Understanding the NTS' role in centrally regulating blood pressure and alterations of neurotransmission or signaling pathways in the NTS may provide rationale for new therapeutic strategies of prevention and treatment. This review summarizes the research findings on autonomic nervous system regulation and arterial blood pressure control by NTS, as well as unresolved questions, in order to provide reference for future investigation.
Solitary Nucleus/physiopathology* ; Hypertension/physiopathology* ; Humans ; Animals ; Autonomic Nervous System/physiopathology* ; Blood Pressure/physiology* ; Baroreflex/physiology* ; Renin-Angiotensin System/physiology* ; Sympathetic Nervous System/physiology*

This study predicts the quality markers(Q-markers) for the cough-relieving and phlegm-expelling effects of Kening Granules based on pharmacodynamics, plasma drug chemistry, network pharmacology, and pharmacokinetics. Strong ammonia solution spray and phenol red secretion assays were employed to evaluate the cough-relieving and phlegm-expelling effects of Kening Granules. Twentysix absorbed prototype components of Kening Granules were identified by ultra high performance liquid chromatography coupled with QExactive Plus quadrupole/Orbitrap high resolution mass spectrometry(UHPLC-Q-Exactive Plus Orbitrap HRMS). Through network pharmacology, 11 potential active components were screened out for the cough-relieving and phlegm-expelling effects of Kening Granules. The 11 components acted on 40 common targets such as IL6, TLR4, and STAT3, which mainly participated in PI3K/Akt, HIF-1, and EGFR signaling pathways. Pharmacokinetic quantitative analysis was performed for 7 prototype components. Three compounds including azelaic acid, caffeic acid, and vanillin were identified as Q-markers for the cough-relieving and phlegm-expelling effects of Kening Granules based on their effectiveness, transmissibility, and measurability. The results of this study are of great significance for clarifying the pharmacological substance basis, optimizing the quality standards, and promoting the clinical application of Kening Granules.
Drugs, Chinese Herbal/administration & dosage* ; Network Pharmacology ; Cough/blood* ; Male ; Humans ; Animals ; Rats ; Rats, Sprague-Dawley ; Biomarkers/blood* ; Quality Control ; Chromatography, High Pressure Liquid ; Antitussive Agents/chemistry*

A high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS) method was established for simultaneous determination of seven characteristic components from the active fraction of Alpiniae Officinarum Rhizoma in rat plasma, including galangin, kaempferol, kaempferide, pinocembrin, 1,7-diphenyl-4-en-3-heptanone, 5-hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-3-heptanone(DHPA), and 7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-4-en-3-heptanone(DPHB). The new developed HPLC-MS/MS method was applied to study the pharmacokinetics of the 7 characteristic components in rats with Helicobacter pylori gastritis. A Waters Sunfire C_(18) column(2.1 mm×150 mm, 3.5 μm) was used. The acetonitrile-aqueous solution(containing 0.1% formic acid) was adopted as the mobile phase for gradient elution. Seven components and internal standard(chlorogenic acid) were separated within 12 min. Mass spectrometric detection was performed in multiple reaction monitoring(MRM) mode using electrospray ionization(ESI) source with fast switching between positive and negative ions. The method was verified by specificity, linearity, precision, accuracy, recovery, matrix effect, and stability and met the requirements of pharmacokinetic study on the 7 components in rat plasma. Pharmacokinetic results showed that the average peak time(T_(max)) of the 7 components was 0.31-2.19 h, their elimination half-life(t_(1/2)) was 5.26-16.65 h, and the average residence time(MRT) was 6.29-31.03 h after the oral administration of the active fraction of Alpiniae Officinarum Rhizoma to rats with H. pylori gastritis. The plasma exposure levels of galangin and DHPA were higher than those of the other components. The concentration-time curves of four detected flavonoids showed obvious double peaks. This study elucidated the pharmacokinetic characteristics of 7 characteristic components from the active fraction of Alpiniae Officinarum Rhizoma in rats with H. pylori gastritis, providing a scientific basis for the identification of the pharmacodynamic substances of Alpiniae Officinarum Rhizoma for treatment of H. pylori gastritis and the clinical application of Alpiniae Officinarum Rhizoma in the prevention and treatment of H. pylori gastritis.
Animals ; Rats ; Chromatography, High Pressure Liquid/methods* ; Tandem Mass Spectrometry/methods* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Helicobacter pylori/drug effects* ; Alpinia/chemistry* ; Rats, Sprague-Dawley ; Gastritis/metabolism* ; Helicobacter Infections/metabolism* ; Flavonoids/blood* ; Rhizome/chemistry* ; Liquid Chromatography-Mass Spectrometry

OBJECTIVE: To assess the efficacy of Qingda Granule (QDG) in ameliorating hypertension-induced cardiac damage and investigate the underlying mechanisms involved. METHODS: Twenty spontaneously hypertensive rats (SHRs) were used to develope a hypertension-induced cardiac damage model. Another 10 Wistar Kyoto (WKY) rats were used as normotension group. Rats were administrated intragastrically QDG [0.9 g/(kg•d)] or an equivalent volume of pure water for 8 weeks. Blood pressure, histopathological changes, cardiac function, levels of oxidative stress and inflammatory response markers were measured. Furthermore, to gain insights into the potential mechanisms underlying the protective effects of QDG against hypertension-induced cardiac injury, a network pharmacology study was conducted. Predicted results were validated by Western blot, radioimmunoassay immunohistochemistry and quantitative polymerase chain reaction, respectively. RESULTS: The administration of QDG resulted in a significant decrease in blood pressure levels in SHRs (P<0.01). Histological examinations, including hematoxylin-eosin staining and Masson trichrome staining revealed that QDG effectively attenuated hypertension-induced cardiac damage. Furthermore, echocardiography demonstrated that QDG improved hypertension-associated cardiac dysfunction. Enzyme-linked immunosorbent assay and colorimetric method indicated that QDG significantly reduced oxidative stress and inflammatory response levels in both myocardial tissue and serum (P<0.01). CONCLUSIONS Both network pharmacology and experimental investigations confirmed that QDG exerted its beneficial effects in decreasing hypertension-induced cardiac damage by regulating the angiotensin converting enzyme (ACE)/angiotensin II (Ang II)/Ang II receptor type 1 axis and ACE/Ang II/Ang II receptor type 2 axis.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Hypertension/pathology* ; Renin-Angiotensin System/drug effects* ; Rats, Inbred SHR ; Oxidative Stress/drug effects* ; Male ; Rats, Inbred WKY ; Blood Pressure/drug effects* ; Myocardium/pathology* ; Rats ; Inflammation/pathology*

OBJECTIVE: To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills (YXQNP) combined with amlodipine in treating patients with grade 1 hypertension. METHODS: This is a multicenter, randomized, double-blind, and placebo-controlled study. Adult patients with grade 1 hypertension of blood deficiency and Gan (Liver)-yang hyperactivity syndrome were randomly divided into the treatment or the control groups at a 1:1 ratio. The treatment group received YXQNP and amlodipine besylate, while the control group received YXQNP's placebo and amlodipine besylate. The treatment duration lasted for 180 days. Outcomes assessed included changes in blood pressure, Chinese medicine (CM) syndrome scores, symptoms and target organ functions before and after treatment in both groups. Additionally, adverse events, such as nausea, vomiting, rash, itching, and diarrhea, were recorded in both groups. RESULTS: A total of 662 subjects were enrolled, of whom 608 (91.8%) completed the trial (306 in the treatment and 302 in the control groups). After 180 days of treatment, the standard deviations and coefficients of variation of systolic and diastolic blood pressure levels were lower in the treatment group compared with the control group. The improvement rates of dizziness, headache, insomnia, and waist soreness were significantly higher in the treatment group compared with the control group (P<0.05). After 30 days of treatment, the overall therapeutic effects on CM clinical syndromes were significantly increased in the treatment group as compared with the control group (P<0.05). After 180 days of treatment, brachial-ankle pulse wave velocity, ankle brachial index and albumin-to-creatinine ratio were improved in both groups, with no statistically significant differences (P>0.05). No serious treatment-related adverse events occurred during the study period. CONCLUSIONS Combination therapy of YXQNP with amlodipine significantly improved symptoms such as dizziness and headache, reduced blood pressure variability, and showed a trend toward lowering urinary microalbumin in hypertensive patients. These findings suggest that this regimen has good clinical efficacy and safety. (Registration No. ChiCTR1900022470).
Humans ; Amlodipine/adverse effects* ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Hypertension/complications* ; Middle Aged ; Treatment Outcome ; Drug Therapy, Combination ; Adult ; Blood Pressure/drug effects* ; Double-Blind Method ; Aged ; Antihypertensive Agents/adverse effects*