Progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en adultos jóvenes / Progression of blood pressure components and correlation with anthropometric and laboratory measurements in young adults

Introducción: La presencia de hipertensión arterial en población joven aumenta el riesgo de eventos cardiovasculares en la mediana edad y como consecuencia una morbimortalidad prematura. El propósito de este estudio es evaluar la progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en estudiantes de la Universidad Nacional de Asunción- Paraguay. Materiales y métodos: Se realizó un estudio descriptivo correlacional, longitudinal, prospectivo, desde el año 2013 hasta el año 2017 evaluando al inicio 284 universitarios y 240 al final de las carreras. Se midieron variables sociodemográficas, antropométricas, presión arterial, determinaciones bioquímicas. La progresión de los componentes de la presión arterial, de las variables antropométricas y clínicas se calcularon mediante la prueba T de muestras relacionadas. La correlación de la presión arterial sistólica y presión arterial diastólica con las variables antropométricas y laboratoriales con la correlación de Pearson. Resultados: La progresión de los componentes de la presión arterial presentó una diferencia estadísticamente significativa en la presión arterial sistólica, presión arterial diastólica y presión de pulso. En relación con las características antropométricas y clínicas de los estudiantes se encontró una diferencia estadísticamente significativa entre la medición inicial y final en el peso, perímetro abdominal, glicemia, insulina, colesterol total, colesterol de alta densidad, colesterol de baja densidad, triglicéridos y proteína C reactiva. La correlación más importante encontrada entre las medidas antropométricas con la presión arterial sistólica y presión arterial diastólica fue la circunferencia abdominal. Conclusión: Se encontró aumento de la tendencia de la presión arterial y de otros factores de riesgo cardiovascular en universitarios.

Introduction: The presence of arterial hypertension in young population increases the risk of cardiovascular events in middle age and as a consequence premature morbimortality. The purpose of this study was to evaluate the progression of blood pressure components and the correlation with anthropometric and laboratory measurements in students of the National University of Asuncion, Paraguay. Materials and methods: A descriptive correlational, longitudinal, prospective, descriptive study was conducted from 2013 to 2017 evaluating at the beginning 284 undergraduates and 240 at the end of the careers. Sociodemographic variables, anthropometric variables, blood pressure, biochemical determinations were measured. The progression of blood pressure components, anthropometric and clinical variables were calculated using the related samples t-test. The correlation of systolic blood pressure and diastolic blood pressure with anthropometric and laboratory variables was correlated with Pearson's correlation. Results: The progression of blood pressure components presented a statistically significant difference in systolic blood pressure, diastolic blood pressure and pulse pressure. In relation to the anthropometric and clinical characteristics of the students, a statistically significant difference was found between the initial and final measurements in weight, abdominal perimeter, glycemia, insulin, total cholesterol, high-density cholesterol, low-density cholesterol, triglycerides, and C-reactive protein. The most important correlation found between anthropometric measurements with systolic blood pressure and diastolic blood pressure was abdominal circumference. Conclusion: An increase in the trend of blood pressure and other cardiovascular risk factors was found in university students.

The preventive effect and mechanism of Dayuanyin in hypoxic pulmonary hypertension through NF-κB signaling pathway / 药学学报

Dayuanyin (DYY) has been shown to reduce lung inflammation in both coronavirus disease 2019 (COVID-19) and lung injury. This experiment was designed to investigate the efficacy and mechanism of action of DYY against hypoxic pulmonary hypertension (HPH) and to evaluate the effect of DYY on the protection of lung function. Animal welfare and experimental procedures are approved and in accordance with the provision of the Animal Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Science. Male C57/BL6J mice were randomly divided into 4 groups: control group, model group, DYY group (800 mg·kg-1), and positive control sildenafil group (100 mg·kg-1). The animals were given control solvents or drugs by gavage three days in advance. On day 4, the animals in the model group, DYY group and sildenafil group were kept in a hypoxic chamber containing 10% ± 0.5% oxygen, and the animals in the control group were kept in a normal environment, and the control solvent or drugs continued to be given continuously for 14 days. The right ventricular systolic pressure, right ventricular hypertrophy index, organ indices and other metrics were measured in the experimental endpoints. Meantime, the expression levels of the inflammatory factors in mice lung tissues were measured. The potential therapeutic targets of DYY on pulmonary hypertension were predicted using network pharmacology, the expression of nuclear factor kappa B (NF-κB) signaling pathway-related proteins were measured by Western blot assay. It was found that DYY significantly reduced the right ventricular systolic pressure, attenuated lung injury and decreased the expression of inflammatory factors in mice. It can also inhibit hypoxia-induced activation of NF-κB signaling pathway. DYY has a protective effect on lung function, as demonstrated by DYY has good efficacy in HPH, and preventive administration can slow down the disease progression, and its mechanism may be related to inhibit the activation of NF-κB and signal transducer and activator of transcription 3 (STAT3) by DYY.

Right ventricular systolic pressure – Non-invasive bedside predictor of mortality and readmission in heart failure with reduced and preserved ejection fraction hospitalization

Objective: To study the prognostic role of right ventricular systolic pressure (RVSP) in patients with heart failure (HF). Background: Although RVSP is a readily available echocardiographic parameter, it is often underused. Its prognostic role in patients with heart failure is not well established compared with pulmonary artery pressure measured by right heart catheterization. Methods: This single-center retrospective cohort study included patients with acute heart failure hospitalization admitted to the hospital from January 2005 to December 2018. The primary predictor was right ventricular systolic pressure (RVSP) obtained from bedside transthoracic echocardiography at admission. We divided RVSP into two groups, RVSP <40 mm Hg (reference group) and RVSP 40 mm Hg. Primary outcome was all-cause mortality. Secondary outcomes were all-cause readmission and cardiac readmission. We conducted propensity-score matching and applied cox-proportional hazard model to compute hazard ratio (HR) with 95% confidence interval (CI). Results: Out of 972 HF patients, 534 patients had RVSP <40 mm Hg and 438 patients had RVSP 40 mm Hg. Patients with RVSP 40 mm Hg compared with RVSP <40 mm Hg were associated with higher rates of death [HR: 1.60, 95% CI: 1.22e2.09, P-value ¼ 0.001], all-cause readmissions [HR: 1.37, 95% CI: 1.09 e1.73, P-value ¼ 0.008] and cardiac readmissions [HR: 1.41, 95% CI: 1.07e1.85, P-value ¼ 0.014]. Conclusion: Higher RVSP (40 mm Hg) in HF patients was associated with higher rates of death, allcause readmissions, and cardiac readmissions. RVSP can be considered as a prognostic marker for mortality and readmission.P

Relación de la presión sistólica de la arteria pulmonar medida por ecocardiograma con el tiempo y el tipo de terapia de reemplazo renal / The relationship between systolic pressure of the pulmonary artery measured by echocardiogram and the duration and type of renal replacement therapy

Resumen Introducción: Las alteraciones secundarias a la enfermedad renal crónica (ERC), como inflamación sistémica, anemia y sobrecarga hídrica, son un sustrato importante para el desarrollo de hipertensión arterial pulmonar. Objetivo: Valorar la relación de la presión sistólica de la arteria pulmonar (PSAP) por ecocardiograma con el tiempo y el tipo de terapia de reemplazo renal (TRR) en pacientes con ERC. Método: Estudio observacional, retrospectivo, llevado a cabo en el Hospital de Especialidades del Centro Médico Nacional La Raza, en el que se analizaron medidas de tendencia central y medidas de dispersión. Para comparar porcentajes se utilizó la prueba de χ2 con el programa estadístico SPSS 25. Resultados: Se incluyeron 141 pacientes con ERC en TRR con diálisis peritoneal o hemodiálisis. Se clasificaron de acuerdo con la PSAP en normal (30 pacientes, 21.28%), leve (43 pacientes, 30.5%), moderada (16 pacientes, 12%) y grave (52 pacientes, 36.88%). El tiempo de TRR está relacionado con una PSAP mayor, con 3.53 años en caso de PSAP normal, 5.51 años en caso de PSAP leve, 6.00 años para la PSAP moderada y 6.38 años para la PSAP grave. La PSAP grave se presentó en 13 de 56 pacientes en diálisis peritoneal y en 39 de 85 en hemodiálisis (p = 0.034). Conclusiones: Se encontró que existe relación entre la PSAP con el tiempo y el tipo de sustitución renal en pacientes con ERC.

Abstract Introduction: The disorders secondary to chronic kidney disease (CKD), such as systemic inflammation, anemia, and fluid overload are an important substrate for the development of pulmonary arterial hypertension. Objective: To assess the relationship between pulmonary artery systolic pressure (PASP) on echocardiogram and the duration and type of renal replacement therapy (RRT) in patients with CKD. Method: A retrospective observational study at Hospital de Especialidades del Centro Médico Nacional La Raza. The analysis was performed using measures of central tendency and dispersion. Chi square was used to compare percentages through the SPSS 25 statistical program. Results: A total of 141 patients with CKD on RRT with peritoneal dialysis or hemodialysis were included. They were classified according to PASP as normal (30 patients, 21.28%), mild (43 patients, 30.5%), moderate (16 patients, 12%) and severe (52 patients, 36.88%). The duration of RRT is related to a higher PASP, with 3.53 years for a normal PASP, 5.51 years for mild PASP, 6.00 years for moderate PASP, and 6.38 for those with severe PASP. Severe PASP occurred in 13 of 56 patients on peritoneal dialysis and 39 of 85 patients on hemodialysis (p = 0.034). Conclusions: This study found a relationship between PASP and the duration and type of renal replacement in patients with CKD.

Combining ventilation efficiency and peak systolic blood pressure in prognostic assessment of patients with chronic heart failure / 中华全科医师杂志

Objective:To analyze the value of minute ventilation to carbon dioxide production slope (VE/VCO 2 slope) combined with peak systolic blood pressure (SBP) in predicting prognosis for patients with chronic heart failure (CHF). Methods:A total of 170 patients with CHF who visited the Cardiac Rehabilitation Center of Tongji Hospital Affiliated to Tongji University and completed cardiopulmonary exercise test from March 2007 to December 2018 were enrolled in the study. The clinical data, cardiopulmonary exercise testing results and follow-up information of patients were collected to explore the predictors of all-cause mortality in patients with CHF.Results:The median follow-up time was 647 (182-1 764) days. All-cause death occurred in 34 patients. Compared with surviving patients, the proportion of diabetes and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) use in fatal patients was significantly higher ( P<0.01). The VE/VCO 2 slope and peak SBP*VE/VCO 2 in the fatal patients were significantly higher, and the peak oxygen consumption (peak VO 2) was lower than those in the surviving patients ( P<0.01). The areas under the receiver operating characteristic curve (AUC) of VE/VCO 2 slope and peak SBP*VE/VCO 2 in predicting all-cause mortality in patients with CHF were 0.648 ( P=0.008) and 0.681 ( P=0.001), respectively; the optimal thresholds were >40.95 ( P=0.008) and > 5 423.50 mmHg (1 mmHg=0.133 kPa, P=0.006), the sensitivity was 0.559 and 0.588, and the specificity was 0.728 and 0.735, respectively. Multivariate Cox regression analysis showed that after adjusting for age, gender, diabetes and ACEI/ARB use, VE/VCO 2 slope ( HR=2.12, P=0.036) and peak SBP*VE/VCO 2 ( HR=2.42, P=0.016) were independent risk factors for all-cause mortality in patients with CHF. Conclusion:Compared to the traditional index VE/VCO 2 slope, a novel index peak SBP* VE/VCO 2 provides a relatively better predictive value for all-cause death of CHF patients.

Factors affecting the elevation of inter-arm systolic blood pressure difference in a physical examination population / 中华健康管理学杂志

Objective:To analyze the related factors affecting the inter-arm systolic blood pressure difference (IASBPD) in a physical examination population.Methods:A total of 3 600 adults who underwent physical examination and completed the arteriosclerosis test in the first affiliated hospital of Anhui medical university from January 2019 to June 2021 were selected as the participants by systematic sampling method. Data on age, sex, and history of smoking, heavy drinking, hypertension, type 2 diabetes, and coronary heart disease were recorded. The height, weight, waist circumference, hip circumference, total muscle, total fat and body fat ratio were measured, and body mass index was calculated. The blood pressure of the limbs, ankle brachial index (ABI) were measured synchronously with the arteriosclerosis tester of the Chinese Academy of Sciences, and the IASBPD were calculated. According to the IASBPD value, the participants were divided into two groups: IASBPD<10 mmHg (1 mmHg=0.133 kPa) group and IASBPD≥10 mmHg group, The differences between the two groups were compared, and the related influencing factors of IASBPD were analyzed by multivariate logistic regression.Results:Weight, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, total muscle, total fat, body fat rate, history of hypertension, proportion of type 2 diabetes mellitus, and proportion of history of coronary heart disease in the IASBPD≥10 mmHg group was higher than that of IASBPD<10 mmHg group [(69.1±11.2) vs (65.3±10.8) kg, (25.6±3.4) vs (24.4±3.3) kg/m 2, (91.3±11.3) vs (87.8±10.6) cm, (98.5±10.4) vs (96.5±9.8) cm, (139.7±20.0) vs (129.7±17.6) mmHg, (80.3±11.6) vs (76.7±10.1) mmHg, (47.5±9.1) vs (45.3±8.8) kg, (19.4±7.0) vs (17.6±6.4) kg, (27.9%±8.5%) vs (26.8%±8.1%), 41.1% vs 29.3%, 16.6% vs 11.7%, 13.1% vs 7.3%] (all P<0.05); ABI was lower than that in IASBPD<10 mmHg group [(1.15±0.11) vs (1.20±0.09)] ( P<0.001). There were no significant differences in height, smoking history and heavy drinking history between the two groups (all P>0.05). Multivariate logistic regression analysis showed that age, systolic blood pressure, body weight and ABI were independent influencing factors of IASBPD≥10 mmHg. Age, systolic blood pressure and body weight were positively correlated with IASBPD≥10 mmHg, while ABI was negatively correlated with IASBPD≥10 mmHg. Conclusion:Increases in age, systolic blood pressure, and body weight and a decrease in ABI are important influencing factors leading to the elevation of IASBPD.

Sedentary postmenopausal women not undergoing hormone replacement therapy can have their blood pressure lowered by performing resistance training: a systematic review and meta-analysis of randomized controlled trials

Abstract Aim: This systematic review and meta-analysis aimed at examining the literature regarding the effects of resistance training (RT) on blood pressure (BP) in postmenopausal women. Methods: The Pubmed, Scopus, Embase, and BVS databases were accessed by two independent reviewers between July 2020, and June 2021 to search for studies that investigated the effects of RT on BP. The eligibility criteria were determined by the PICOT strategy. P: postmenopausal women, I: RT, in which training variables are presented, C: presence of a control group that does not receive any type of intervention, O: BP measured in both groups, at least before and after the intervention, T: randomized controlled trial. For the studies included in the meta-analysis, we calculated the effects sizes based on the net changes in the systolic (SBP) and diastolic (DBP) BP for a random effect model with a confidence interval of 95% and a statistical significance of p < 0.05. Results: The RT group presented a significantly lower SBP (−7.25 mmHg [95% CI: −14.04, −0.45], p = 0.04), while DBP was not statistically significantly different compared to controlled conditions (−2.54 mmHg [95% CI: −5.52, 0.44], p = 0.09). Conclusions: Physically-inactive postmenopausal women who did not take hormone replacement but performed RT exercise had a lower BP value when compared to the control group.

Discussion on heart transplantation indications in patients with end-stage heart failure complicated with reversible pulmonary artery hypertension / 器官移植

Heart transplantation can save the life and improve the quality of life of patients with end-stage heart failure. Nevertheless, it is not suitable for all patients with end-stage heart failure. As a common complication of end-stage heart failure, pulmonary artery hypertension may increase the incidence of right heart failure after heart transplantation, which is associated with the short- and long-term fatality risk in the recipients after heart transplantation. In clinical practice, different transplant centers have different criteria for heart transplantation indications in patients with end-stage heart failure complicated with pulmonary artery hypertension. Accurate preoperative evaluation of surgical indications plays a critical role in determining the success of heart transplantation. In this article, the definition, pathogenesis and effects on heart transplantation, diagnostic methods and reversibility judgment of pulmonary artery hypertension, diagnostic treatment of reversible pulmonary artery hypertension and indications of heart transplantation in patients with end-stage heart failure complicated with reversible pulmonary hypertension were reviewed.

Evaluation of the preventive effect of DL0805-2 against monocrotaline induced rat pulmonary arterial hypertension / 药学学报

In the treatment of hypertensive crisis, the novel Rho kinase inhibitor DL0805-2 can rapidly lower systematic blood pressure, reduce pulmonary artery pressure, and has a significant protective effect on lung injury. This experiment intends to evaluate the efficacy of DL0805-2 against pulmonary arterial hypertension (PAH) and preliminarily reveals its underlying mechanism. Animal welfare and experimental procedures are in accordance with the provision of the Animal Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences. Sprague Dawley (SD) rats were randomly divided into DL0805-2 low, medium, and high dose groups (1, 3, and 10 mg·kg-1), bosentan positive control group, model group, and blank control group. The drug was administered daily on the 7th day after model establishment by monocrotaline injection. On the 25th day of the experiment, relevant indicators were examined to observe the therapeutic effect of DL0805-2 on pulmonary hypertension. DL0805-2 significantly relieved the abnormal changes in the physiological parameters related to PAH induced by monocrotaline, including reducing right ventricular systolic pressure, alleviating cardiac damage caused by pressure overload, and reducing the levels of endothelin-1 and inflammatory factors in lung tissues. DL0805-2 also attenuated pulmonary arteries remodeling. It was preliminarily discovered that DL0805-2 exerts preventive and therapeutic effect on PAH through Rho-kinase pathway. Our results suggested that DL0805-2 had good therapeutic effects on monocrotaline-induced PAH rat model. It intervened early in the disease process, effectively prevented the development of the disease, and reduced the mortality of the diseased animals. The mechanism is related to Rho-kinase pathway.

Plethysmographic variability index as a tool to assess fluid responsiveness in critically ill patients: a correlation study with inferior vena cava distensibility index

Background: In critically ill patients in the intensive care unit (ICU), early aggressive fluid replacement is the cornerstone of resuscitation. Traditionally employed static measures of fluid responsiveness have a poor predictive value. It is therefore imperative to employ dynamic measures of fluid responsiveness that take into account the heart lung interactions in the mechanically ventilated patients. The main objective of this study was to evaluate the reliability of one such non-invasive dynamic index: Plethysmographic variability index (PVI) compared to the widely employed Inferior vena cava distensibility index (dIVC).Methods: Seventy-six adult patients admitted at a tertiary care mixed ICU, who developed hypotension (MAP<65mmHg), were included in the study. PVI was recorded using the MASIMO-7 monitor and dIVC measurements done using Terason ultrasound. Based on the dIVC measurement threshold of 18%, the patients were classified into volume responders and non-responders. The hemodynamic, PVI and dIVC measurements were recorded at pre specified time points following a fluid challenge of 20 ml/kg crystalloid infusion.Results: Baseline PVI values were significantly higher in the responders (22.3±8.2) compared to non-responders (10.1±2.9) (p<0.001) and showed a declining trend at all time points in the responders. Similar declining trend was observed in the dIVC measurements. Overall, the Pearson correlation graph showed strong correlation between dIVC and PVI values at all time points (r=0.678, p=0.001). The ROC curve between the dIVC and PVI values revealed that Baseline PVI (Pre PVI) >15.5% discriminated between responders and non-responders with a 90.2% sensitivity and 75% specificity with an AUC of 0.84 (0.72-0.96) (p<0.001).Conclusions: There is good correlation between PVI values and measured dIVC values at baseline and following a fluid challenge. Thus, PVI may be an acceptable, real time, continuous, surrogate measure of fluid responsiveness in critically ill patients.

Association between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure: a single-center cross-sectional study

ABSTRACT BACKGROUND: Lower urinary tract symptoms significantly worsen quality of life. The hypothesis that they might lead to serious systolic blood pressure alterations through inducing sympathetic nervous activity has not been studied so far. OBJECTIVES: To investigate the relationship between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure. DESIGN AND SETTING: Cross-sectional single-center study on data from a hospital patient record system. METHODS: We evaluated the medical records of all consecutive patients with benign prostate enlargement-related lower urinary tract symptoms admitted between January 2012 and December 2017. Storage and voiding symptoms were assessed separately. International Prostate Symptom Score, uroflowmetry, postvoiding residual urine volume and systolic blood pressure were recorded. Pearson correlation and linear regression analysis were used. RESULTS: Positive correlations were found between systolic blood pressure and all of the storage symptoms. Among these, urgency had the most significant effect. There were 166 patients (41.4%) with urgency for urination, which increased mean systolic blood pressure from 124.88 mmHg (average value in elevated blood pressure group) to 132.28 mmHg (average value in stage-1 hypertension group). Hesitancy in urinating and feeling of incomplete bladder emptying had weak positive correlations with systolic blood pressure. There was a negative correlation between systolic blood pressure and intermittency of urination. CONCLUSIONS: With increasing numbers of urine storage symptoms, systolic blood pressure also increases, while the opposite occurs for voiding symptoms in patients with benign prostate enlargement. We conjecture that storage symptoms may lead to this increase through inducing sympathetic hyperactivity. Further prospective studies with larger groups are needed to confirm these findings.

Study of Prevalence of Pulmonary Artery Hypertension in Portal Hypertensives Patients in RIMS, Ranchi

Background: The development of pulmonary hypertension i.e.mean pulmonary artery pressure (mPAP) above 25 mmHg withnormal capillary wedge pressure and pulmonary vascularresistance(PVR) above 240 dyn/s/cm−5 in association withelevated pressure in portal circulation is known asportopulmonary hypertension (POPH). Comparing withidiopathic PAH, patients with POPH have a worst survivalprofile, with a 3-year survival of only 38% versus78% foridiopathic PAH. Recent evidence from France shows thatPOPH is the fourth most common form of PAH reported overallin the population-based French National Registry, afteridiopathic PAH and PAH associated with connective tissuediseases and con- genital heart disease. The aim of this studyis to evaluate frequency of POPH in portal hypertensivepatient.Materials and Methods: A cross sectional study of patientadmitted in RIMS, medicine department was performedfulfilling features of portal hypertension with ultrasoundshowing splenomegaly, ascites, portal vein diameter more than13 mm, portal vein velocity less than 15 cm/s and uppergastrointestinal endoscopy showing esophageal varices andpatient with connective tissue disease, congenital heartdisease, left ventricular systolic or diastolic dysfunction,valvular heart disease, lungs disease, sleep related breathingdisorder, chronic hemolytic and myeloproliferative disorderwere excluded. All patient underwent screening withechocardiography for measuring pulmonary artery systolicpressure (PASP) and PASP more than 35 mmHg wereconsidered for POPH which was confirmed with right heartcatheterisation by measuring mean pulmonary artery pressure(mPAP) of more than 25 mmHg.Observation: Among forty-two patient in this study, there werethirty-three male patients and nine female patients. POPH wasseen three female and two male patients with total of five out offorty- two with prevalence of 11.9% out of which 7.1% werefemale and 4.8% were male.Conclusion: Portopulmonary hypertension prevalence is 2–6%. In this study pulmonary hypertension is significantly high inportal hypertensive patient with percentage of 11.9% and moreprevalent in female.

Blood pressure changes in 18-59 years old adults in rural area of Shanxi province, China / 中华流行病学杂志

Objective@#To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China.@*Methods@#Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015.@*Results@#The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%.@*Conclusions@#The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.

Diferencia de la presión arterial medida en el brazo vs antebrazo en pacientes con circunferencia de brazo mayor a 34 cm / Difference of blood pressure measured in the arm vs forearm in patients with arm circumference higher than 34 cm

Resumen OBJETIVO Determinar si existe diferencia entre la medición de la presión arterial en el brazo con brazalete de tamaño adecuado para el paciente (circunferencia del brazo > 34 cm) vs medición de la presión arterial en el antebrazo con brazalete estándar (circunferencia de brazo 22-33 cm) en pacientes con circunferencia de brazo > 34 cm. MATERIAL Y MÉTODO Estudio prospectivo, observacional y transversal realizado de enero a junio de 2017. Se incluyeron pacientes de consulta externa del Hospital General de Mexicali con circunferencia del brazo > 34 cm. Se midió la presión arterial en el antebrazo con brazalete estándar, se realizó una segunda toma de la presión arterial en el brazo con brazalete para pacientes con diámetro de brazo mayor a 33 cm. RESULTADOS Se incluyeron 320 pacientes, 67% eran mujeres, con media de edad de 41 años, la circunferencia promedio del brazo fue de 38 cm. En hombres, la media fue de 35 años, con circunferencia promedio del brazo de 38 cm. La media de la presión sistólica en el antebrazo fue de 128.6 ± 12.5 vs 125.5 ± 13.6 mmHg en el brazo, con diferencia de 3.54 con valor p = 0.0007. La media de la presión arterial diastólica en el antebrazo fue de 83.42 ± 8.95 vs 79.21 ± 8.88 mmHg en el brazo, con diferencia entre ambos de 4.21, p ≤ 0.0001. CONCLUSIONES La obtención de la presión arterial en el antebrazo con un brazalete estándar en pacientes con circunferencia del brazo mayor a 34 cm cuando no se cuente con un brazalete apropiado proporcionará cifras similares a las obtenidas con un brazalete adecuado, con lecturas mayores, pero con diferencias por debajo de 5 mmHg.

Abstract OBJECTIVE To determine if there is a difference between measuring blood pressure in the arm with and adequate size bracelet for patients (arm circumference > 34 cm) vs measuring blood pressure in the forearm with a standard bracelet (arm circumference < 22-33 cm) in patients with arm circumference > 34 cm. MATERIAL AND METHOD A prospective, observational, cross-sectional study was done from January to June 2017. Sample: patients from external consult of Hospital General de Mexicali with arm circumference > 34 cm. Blood pressure was measured in the forearm of the patient with a standard bracelet, blood pressure was measured again in the arm with an adequate bracelet (for patients with an arm circumference > 33 cm). RESULTS 320 patients were included for this study, 67% were women, with an average age of 41 years, average arm circumference was of 38 cm. In men, the average age was 35 years with an average arm circumference of 38 cm. Average of the systolic pressure in the forearm was 128.6 ± 12.5 vs 125.5 ± 13.6 mmHg in the arm, with a difference of 3.54 with a p = 0.0007. The average of the diastolic pressure in the forearm was 83.42 ± 8.95 vs 79.21 ± 8.88 mmHg in the arm with a difference of 4.21, p ≤ 0.0001. CONCLUSIONS Measurement of blood pressure in the forearm with a standard bracelet in patients with an arm circumference > 34 cm when we don't have the adequate bracelet will give us similar values compared to the blood pressure in the arm with an adequate bracelet, with higher values but differences below 5 mmHg.

The follow-up observation on the abnormal elevation of fetal pulmonary artery systolic pressure at middle and late stages by Doppler echocardiography / 中华超声影像学杂志

Objective To investigate the outcome of fetus with abnormal increase of pulmonary artery systolic pressure at second and third trimester by color Doppler ultrasound . Methods Ninety-five fetuses with a little or mild tricuspid regurgitation ( control group) and 60 fetuses with moderate and severe tricuspid regurgitation (observation group) were included . The degree ,velocity ,and differential pressure of tricuspid regurgitation were measured and the variations of baseline information and the measured value of pulmonary systolic pressure between the two groups were compared . As for the follow -up on observation group ,the pressure of fetus with high pulmonary systolic pressure ( > 20 mmHg) was repeatedly measured every 4 weeks until it return to normal . Results There were significant differences in terms of gestational weeks ,velocity and pressure of tricuspid regurgitation ,as well as pulmonary systolic pressure between the two groups ( P < 0 .001) . Pulmonary systolic pressure was positively correlated with gestational weeks , velocity and pressure of tricuspid regurgitation ( r = 0 .442 ,0 .998 ,0 .999 ;all P < 0 .001 ) ,but had no correlations with the age of pregnant women ( r = - 0 .001 , P = 0 .674) . The follow-up revealed that ,in observation group , 47 cases ( 78 .3％ , systolic pressure < 50 mmHg ) presented with the decreased pulmonary systolic pressure ,the disappeared or the slight appeared regurgitation before birth ,meanwhile , 13 ( 21 .7％ ,systolic pressure ≥ 50 mmHg) exhibited severe tricuspid regurgitation and persistent pulmonary elevation ,with the highest of more than 70 mmHg accompanying the varying degrees of right heart failure . Only one of 13 fetuses died due to persistent pulmonary hypertension and hypoxia ( oxygen saturation <45％ ) . The fetal pulmonary artery systolic pressure of the remaining 12 cases recovered from 5 to 105 days after birth ,with normal heart function . Conclusions The majority of fetal pulmonary arterial hypertension complicated with obvious tricuspid regurgitation is reversible functional alteration , which can restore normality in most cases before or after birth .

Analysis of influencing factors of carotid atherosclerosis plaque formation and stability in simple type 2 diabetic patients / 吉林大学学报(医学版)

Objective:To explore the related influencing factors of carotid atherosclerosis(AS)plaque formation and stability in the patients with type 2 diabetes mellitus(T2DM),and to provide scientific evidence for early prevention and treatment.Methods:A total of 249 cases of simple T2DM patients were selected.According to the results of carotid artery color Doppler ultrasound,they were divided into AS group,stable plaque group and unstable plaque group.The differences in physicochemical indexes and life style of the patients were compared between three groups;univariate analysis and Logistic regression analysis were used to screen the related influencing factors of carotid AS plaque formation and stability of the T2DM patients.Results:The univariate analysis showed that age,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),non-high density lipoprotein cholesterol (NHDL-C),monocyte/ high density lipoprotein ratio(MHR),smoking ratio(Smoking%),T2DM disease course,high density lipoprotein protein cholesterol(HDL-C)had significant differences between AS group and plague group(P<0.05).There were significant differences in the values of postprandial blood glucose(PBG), systolic blood pressure(SBP),low density lipoprotein cholesterol(LDL-C),HbA1c,MHR,Smoking% and HDL-C of the patients in stable plaque group and unstable plaque group(P<0.05).The Logistic regression analysis showed that high age,HbA1c,NHDL-C,MHR and smoking were the risk factors of the plaque formation and high HDL-C was a protective factor of plaque formation(Age:OR=1.62,P=0.011;HbA1c:OR=1.25, P=0.027;HDL-C:OR=0.65,P=0.009;MHR:OR=3.50,P=0.000;Smoking:OR=2.28,P=0.009;NHDL-C:OR=1.39,P=0.028).High SBP,LDL-C,MHR and smoking were the risk factors of unstable plaque formation,and high HDL-C was a protective factor of unstable plaque formation(SBP:OR=1.5 7,P=0.003;LDL-C:OR=1.99,P=0.000;MHR:OR=3.88,P=0.000;Smoking:OR=2.01,P=0.001;HDL-C:OR=0.53,P=0.001).Conclusion:For the patients with simple T2DM and carotid AS plaque,blood lipid,blood pressure and smoking cessation should be emphasized and HDL-C level should be increased,which can effectively prevent the formation of AS plaque and stabilize the plaque.

Analysis of influencing factors of carotid atherosclerosis plaque formation and stability in simple type 2 diabetic patients / 吉林大学学报(医学版)

Objective: To explore the related influencing factors of carotid atherosclerosis (AS) plaque formation and stability in the patients with type 2 diabetes mellitus (T2DM), and to provide scientific evidence for early prevention and treatment. Methods: A total of 249 cases of simple T2DM patients were selected. According to the results of carotid artery color Doppler ultrasound, they were divided into AS group, stable plaque group and unstable plaque group. The differences in physicochemical indexes and life style of the patients were compared between three groups; univariate analysis and Logistic regression analysis were used to screen the related influencing factors of carotid AS plaque formation and stability of the T2DM patients. Results: The univariate analysis showed that age, fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), non-high density lipoprotein cholesterol (NHDL-C), monocyte/high density lipoprotein ratio (MHR), smoking ratio (Smoking%), T2DM disease course, high density lipoprotein protein cholesterol (HDL-C) had significant differences between AS group and plague group (P<0.05). There were significant differences in the values of postprandial blood glucose (PBG), systolic blood pressure (SBP), low density lipoprotein cholesterol (LDL-C), HbAlc, MHR, Smoking% and HDL-C of the patients in stable plaque group and unstable plaque group (P<0.05). The Logistic regression analysis showed that high age, HbAlc, NHDL-C, MHR and smoking were the risk factors of the plaque formation and high HDL-C was a protective factor of plaque formation (Age: OR=l. 62, P=0. Oil; HbAlc: OR=l. 25, P=0.027; HDL-C: OR=0.65, P = 0.009; MHR: OR= 3.50, P= 0.000; Smoking: OR=2.28, P = 0.009; NHDL-C: OR=l. 39, P = 0.028). High SBP, LDL-C, MHR and smoking were the risk factors of unstable plaque formation, and high HDL-C was a protective factor of unstable plaque formation (SBP: OR=l. 57, P = 0.003; LDL-C: OR=l. 99, P = 0.000; MHR: OR=3.88, P = 0.000; Smoking: OR = 2.01, P = 0.001; HDL-C: OR=0.53, P=0.001). Conclusion: For the patients with simple T2DM and carotid AS plaque, blood lipid, blood pressure and smoking cessation should be emphasized and HDL-C level should be increased, which can effectively prevent the formation of AS plaque and stabilize the plaque.

The clinical analysis of drug induced acute angle-closure glaucoma / 天津医药

@# Objective Toinvestigatetheroleofpulmonaryvalvepressuregradientintheestimationofpulmonary arterysystolicpressures(PASP)inpatientswithatrialseptaldefect(ASD). Methods SixtyeightpatientswithASDand hospitalizedinTianjinMedicalUniversityGeneralHospitalwereincludedinthisstudy.Thetricuspidregurgitationpressure gradientmethodwasusedformeasuringPASPbeforeinterventionalocclusionoperation.Andpulmonaryvalvepressure gradientwasmeasuredthroughpulmonaryvalvevelocitytocalculatecorrectedvalues(PASP’),whichwerecomparedwith those(PASPr)obtainedbyrightcardiaccatheterization(RHC)respectively.ThepatientsweredividedintogroupA(defect size≤15 mm) and group B (defect size>15 mm) by the size of defect. The measurements obtained by ultrasound echocardiography(UCG)andRHCwerecomparedbetweenthetwogroups. Results Therewerestatisticallysignificant differencesbetweenPASP[(31.66±6.76)mmHg],PASP’ [(26.86±6.66)mmHg]andPASPr[(28.79±6.43)mmHg]ingroupA (P＜0.05).ThePASPwassignificantlyhigherthanPASPr[(45.29±13.49)mmHg vs. (34.56±9.47)mmHg](P＜0.05),but therewasnosignificantdifferencebetweenPASP’[(37.30±12.71)mmHg]andPASPringroupB(P＞0.05).Valuesof PASPrwerepositivelycorrelatedwithPASP(r=0.664,0.588respectively,P＜0.01)ingroupAandgroupB.Thecorrelation coefficients of PASPr and PASP’were improved in two groups after adjusted with pulmonary valve pressure gradient (respectively r =0.700,0.645, P＜0.01). Conclusion TheadjustedPASPcalculatedbytricuspidregurgitationpressure gradientmethodwithpulmonaryvalvepressuregradientcanimprovetheaccuracyofechocardiographicestimatesofPASPin ASDpatientswiththedefectsize>15mm.

Controle da pressão central em paciente obeso, após infarto do miocárdio / Control of central pressure in an obese patient, post myocardial infarction

Pacientes hipertensos com evento cardiovascular agudo requerem intervenção adequada com alcance precoce de metas pressóricas pré-definidas, para redução de risco absoluto e residual de desfechos fatais e não fatais. O presente caso clínico trata-se de um paciente obeso, hipertenso que apresentou infarto agudo do miocárdio submetido a cateterismo e angioplastia com sucesso primário. Após alta da Unidade Coronariana, na enfermaria evoluiu com elevação dos valores pressóricos. Foram realizados teste de bioimpedância (para verificar volumetria) e avaliação da pressão central por tonometria de aplanação da artéria radial com Sphygmocor. A conduta a seguir foi orientada pelos resultados dos paramentos hemodinâmicos e realizada a escolha da medicação ideal para o tratamento

Hypertensive patients with an acute cardiovascular event require adequate intervention with early reach of pre-defined blood pressure goals to reduce absolute and residual risk of fatal and nonfatal outcomes. The present case is a hypertensive patient who presented acute myocardial infarction undergoing catheterization and angioplasty with primary success. After discharge from the Coronary Unit, the ward evolved with elevation of blood pressure values. Bioimpedance test (to verify volumetry) and evaluation of the central pressure by tonometry of radial artery aplanation with Sphygmocor were performed. The following conduct was guided by the results of the hemodynamic parameters and the choice of the ideal medication for the treatment was made.

Effects of dioscin on rat myocardial contractility / 中国药理学通报

Aim To investigate the effects of dioscin ( Dio) on rat myocardial contractility. Methods Left ventricular contractile function was measured using the Langendorff non-recirculating mode of isolated rat heart perfusion. Effects of low, middle and high concentra-tion of Dio were investigated by measuring left ventricu-lar systolic pressure ( LVSP ) and left ventricular end diastolic pressure ( LVEDP) . Also, peak rates of rise/fall of left ventricular pressure ( ± dp/dtmax ) of isolated rat heart were calculated. Effects of Dio on intracellu-lar free calcium concentration in rat H9 c2 cells were measured by using the confocal microscopy. Mitochon-drial membrane potential was detected with multifunc-tional microplate reader. Results With 0. 1, 1 μmol · L-1 Dio, LVSP were significantly enhanced from (11. 55 ± 0. 52), (10. 53 ± 0. 28) kPa to (13. 08 ± 0. 72), (12. 53 ±0. 64) kPa(P<0. 01); +dp/dtmax were dramatically increased from ( 0. 38 ± 0. 10 ) , (0. 40 ± 0. 07) kPa·ms-1 to (0. 42 ± 0. 11), (0. 43 ± 0. 02) kPa·ms-1(P<0. 05). With the 10μmol· L-1 Dio, LVSP and + dp/dtmax were both decreased from (12. 13 ± 0. 33) kPa and (0. 42 ± 0. 04) kPa· ms-1 to ( 9. 46 ± 0. 77 ) kPa and ( 0. 24 ± 0. 04 ) kPa ·ms-1 (P <0. 01). With 0. 1, 1, 10 μmol·L-1 Dio, the relative fluorescence intensity of intracellular free calcium concentrations was increased significantly from (16. 62 ± 0. 89) to (21. 48 ± 0. 80), (25. 68 ± 0. 69) and (19. 84 ± 0. 66)(P <0. 01)respectively. 0. 1, 1μmol·L-1 Dio showed no significant effects on the mitochondrial membrane potential of rat H9 c2 cells, while with effects of 10 μmol·L-1 Dio, the ra-tio of JC-1 monomer and J-aggregates was changed from (1. 14 ± 0. 03) to (1. 35 ± 0. 06)(P<0. 01), indica-ting a decrease in the mitochondrial membrane poten-tial. Conclusion Low and middle concentrations of Dio show a positive inotropic effect on isolated rat heart, as the LVSP and + dp/dtmax are enhanced, which may concern with the increase of the intracellu-lar concentration of Ca2+. It will not cause the calcium overload while the intracellular concentration of Ca2+ is increased by low and middle concentration of Dio in the myocytes except high concentration of Dio.