BACKGROUND

Blood pressure is an important vital sign measured not only in hypertension but also among hospitalized patients for clinical evaluation of the actual hemodynamic status. In the digital era, mercury and aneroid sphygmomanometers are being replaced by automated monitors despite lacking validation and recommendations for their use, especially in acute illness.

To compare automated and manual blood pressure measurement among hospitalized medical patients with acute illness.

A crossover design was used in a single tertiary hospital. Blood pressure was recorded from 216 participants, with 432 observations from an automated monitor (Omron HBP1120) and a mercury sphygmomanometer. Automated and manual BP recordings were done twice following the same arm sequential method. The average of the two recordings was used for comparison.

Most participants were female, elderly, obese, and had cardiac complaints. Comparing automated and manual methods, the mean difference for systolic was 1.47 ± 12.12 (p = 0.08) and 1.82 ± 10.99 (p=0.02) for diastolic. Subgroup analysis revealed that males had higher manual systolic BP than females (pairwise p-value= 0.017). Overweight and obese participants had higher automated systolic and diastolic BP (p=0.04). Overweight and obese participants had significantly higher systolic and diastolic BP regardless of the method. Significantly higher diastolic BP for different age groups and areas of admission (p=0.02) were observed from the automated method.

Automated BP monitoring showed a significant difference in diastolic BP recordings. Automated BP monitors should be used with caution, especially in interpreting diastolic BP among hospitalized patients.

Humans ; Blood Pressure/physiology* ; Renal Insufficiency, Chronic ; Hypertension/drug therapy* ; Antihypertensive Agents/therapeutic use*

Humans ; Albumins ; Albuminuria/urine* ; Blood Pressure ; China/epidemiology* ; Creatinine ; Risk Factors ; Aged

Sodium ; Wastewater ; Potassium ; Diet ; Blood Pressure ; China ; Sodium, Dietary ; Sodium Chloride, Dietary

Background: Hypertension is associated with the improvement of cardiovascular disease and all-cause mortality. A healthy diet based on consuming natural foods can prevent and control hypertension. Objective: The aim of this study was to analyze the effectiveness of tomato and cucumber juice in reducing the blood pressure of hypertensive patients. Methods: The study used a quasi-experiment pretest-posttest control group design. The target population are people with hypertension Stage 1, people living in urban area - Cibiru Health Centre Work Area. Purposive sampling was used and the sample size was calculated using the average comparison formula with effect size=0.9, α=0.05, β =0.2. Forty-five subjects involved in the study were divided into three groups (15 subjects were given tomato juice, 15 subjects were given cucumber juice, and 15 subjects were given treatment with mineral water (control group)., This research used 100 grams of ripe red tomatoes, 100 grams of fresh cucumber, and 200 ml of water. The data collected were patient characteristics and blood pressure. The ANOVA analysis test and the Bonferroni Post Hoc test were used to analyze the data. Results: The results of the study showed a difference in blood pressure reduction in each group. The decrease in systolic blood pressure in the tomato juice group was 7.3+3.1, the cucumber juice group was 4.2+3.3, and the control group was -0.0+2.5 (p=0.0001). The decrease in diastolic blood pressure in the group given tomato juice was 9.2+3.1, the group given cucumber juice was 7.6+3.4, and the control group was 0.4+2.1 (p=0.0001). Conclusion There is a difference in blood pressure reduction between the group given tomato juice and the control group, and there is a difference in blood pressure between the group given cucumber juice and the control group.
Blood Pressure

BACKGROUND Hypertension is the most common risk factor for cardiovascular disease in the Philippines. Despite the availability of antihypertensive medications that are effective, safe, and tolerated by Filipino patients, the numbers of uncontrolled hypertensives are still increasing. Several factors play in the poor control of blood pressure, particularly resistant hypertension and hyperactive sympathetic nervous system. Renal denervation therapy is a novel device that has been shown to lower blood pressure in patients with resistant and difficult-to-treat hypertension and is deemed safe in clinical trials. A Philippine Working Group composed of specialists in cardiology, hypertension, vascular surgery, and clinical epidemiology has come up with consensus statements in identifying patients who will benefit from the procedure. Locally, there is a need to have hypertension centers treating uncontrolled and resistant hypertension and offer renal denervation therapy to appropriate Filipino patients.
Blood Pressure

This study was designed to investigate the cardiovascular effects of sulfur dioxide (SO₂) in the caudal ventrolateral medulla (CVLM) of anesthetized rats and its mechanism. Different doses of SO₂ (2, 20, 200 pmol) or artificial cerebrospinal fluid (aCSF) were injected into the CVLM unilaterally or bilaterally, and the effects of SO₂ on blood pressure and heart rate of rats were observed. In order to explore the possible mechanisms of SO₂ in the CVLM, different signal pathway blockers were injected into the CVLM before the treatment with SO₂ (20 pmol). The results showed that unilateral or bilateral microinjection of SO₂ reduced blood pressure and heart rate in a dose-dependent manner (P < 0.01). Moreover, compared with unilateral injection of SO₂ (2 pmol), bilateral injection of 2 pmol SO₂ produced a greater reduction in blood pressure. Local pre-injection of the glutamate receptor blocker kynurenic acid (Kyn, 5 nmol) or soluble guanylate cyclase (sGC) inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 1 pmol) into the CVLM attenuated the inhibitory effects of SO₂ on both blood pressure and heart rate. However, local pre-injection of nitric oxide synthase (NOS) inhibitor N^G-Nitro-L-arginine methyl ester (L-NAME, 10 nmol) only attenuated the inhibitory effect of SO₂ on heart rate but not blood pressure. In conclusion, SO₂ in rat CVLM has cardiovascular inhibitory effects, and its mechanism is related to the glutamate receptor and NOS/cGMP signal pathways.
Animals ; Rats ; Heart Rate ; Sulfur Dioxide ; Blood Pressure ; Cyclic GMP ; Receptors, Glutamate

The alteration of pulmonary artery pressure is an important physiological indicator to reflect the organism's adaptation to acclimatization or the pathological injury in response to high-altitude hypoxic environment. The effects of hypoxic stress at different altitudes for different time on pulmonary artery pressure are different. There are many factors involved in the changes of pulmonary artery pressure, such as the contraction of pulmonary arterial smooth muscle, hemodynamic changes, abnormal regulation of vascular activity and abnormal changes of cardiopulmonary function. Understanding of the regulatory factors of pulmonary artery pressure in hypoxic environment is crucial in clarifying the relevant mechanisms of hypoxic adaptation, acclimatization, prevention, diagnosis, treatment and prognosis of acute and chronic high-altitude diseases. In recent years, great progress has been made in the study regarding the factors affecting pulmonary artery pressure in response to high-altitude hypoxic stress. In this review, we discuss the regulatory factors and intervention measures of pulmonary arterial hypertension induced by hypoxia from the aspects of hemodynamics of circulatory system, vasoactive state and changes of cardiopulmonary function.
Humans ; Altitude ; Arterial Pressure ; Acclimatization ; Hypoxia ; Muscle, Smooth

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 10 μg/m³ in the 1 year-mean PM_2.5 concentration (FPM_1Y) 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 FPM_1Y but in an approximately linear range when the FPM_1Y concentration was < 70 µg/m³; 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.
Middle Aged ; Humans ; Aged ; Particulate Matter/analysis* ; Blood Pressure ; Air Pollutants/analysis* ; Follow-Up Studies ; Hypertension/etiology* ; East Asian People ; Environmental Exposure/analysis* ; Air Pollution/analysis* ; China/epidemiology*

BACKGROUND: Intensive systolic blood pressure (SBP) control improved outcomes in the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Whether baseline serum lipid parameters influence the benefits of intensive SBP control is unclear. METHODS: The STEP trial was a randomized controlled trial that compared the effects of intensive (SBP target of 110 to <130 mmHg) and standard (SBP target of 130 to <150 mmHg) SBP control in Chinese patients aged 60 to 80 years with hypertension. The primary outcome was a composite of cardiovascular disease events. A total of 8283 participants from the STEP study were included in this post hoc analysis to examine whether the effects of the SBP intervention differed by baseline low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) concentrations. RESULTS: Regardless of the randomized SBP intervention, baseline LDL-C and non-HDL-C concentrations had a J-shaped association with the hazard of the primary outcome. However, the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline LDL-C level ( P for interaction = 0.80) and non-HDL-C level ( P for interaction = 0.95). Adjusted subgroup analysis using tertiles in LDL-C1 (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.52-1.13; P = 0.18), LDL-C2 (HR, 0.81; 95% CI, 0.55-1.20; P = 0.29), and LDL-C3 (HR, 0.68; 95% CI, 0.47-0.98; P = 0.04) was provided, with an interaction P value of 0.49. Similar results were showed in non-HDL-C1 (HR, 0.87; 95% CI, 0.59-1.29; P = 0.49), non-HDL-C2 (HR, 0.70; 95% CI, 0.48-1.04; P = 0.08), and non-HDL-C3 (HR, 0.67; 95% CI, 0.47-0.95; P = 0.03), with an interaction P -value of 0.47. CONCLUSION: High baseline serum LDL-C and non-HDL-C concentrations were associated with increased risk of primary cardiovascular disease outcome, but there was no evidence that the benefit of the intensive SBP control differed by baseline LDL-C and non-HDL-C concentrations. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03015311.
Aged ; Humans ; Cardiovascular Diseases ; Blood Pressure/physiology* ; Cholesterol, LDL ; Hypertension ; Cholesterol ; Risk Factors