Risk factors of abnormal urinary albumin/creatinine ratio in people with obesity / 中华内分泌代谢杂志

Objective:To explore the clinical characteristics and risk factors of abnormal urinary albumin/creatinine ratio(UACR) in obese population.Methods:Baseline data from 2011 to 2012 in Henan Sub-center of"Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal(REACTION) study"were utilized and those of body mass index≥28 kg/m 2 were screened. The patients were divided into UACR normal group and UACR abnormal group(101 pairs) upon being matched on a 1∶1 basis by age and gender. Multivariate logistic regression analysis, receiver operating characteristic(ROC) curve, and restricted cubic spline(RCS)analysis were performed to explore the risk factors for abnormal UACR. Results:Compared with the normal UACR group, the UACR abnormal group had a higher number of alcohol consumers, a higher prevalence of hypertension, elevated systolic blood pressure, and triglyceride(all P<0.05). Multivariate logistic regression analysis showed that alcohol consumption( P=0.008), systolic blood pressure( P<0.001), triglyceride( P=0.049), and homeostasis model assessment for insulin resistance(HOMA-IR, P=0.033) were independent risk factors for abnormal UACR in obese people. The ROC curve analysis indicated that systolic blood pressure had the strongest diagnostic performance as a single factor(ROC curve area=0.801), and there was no significant difference in diagnostic performance compared to multiple factors combination. RCS analysis results showed that the probability of abnormal UACR increased monotonically with the increase of systolic blood pressure when the systolic blood pressure was between 130 and 158 mmHg(1 mmHg=0.133 kPa). When systolic blood pressure was not in the interval, the probability of abnormal UACR did not change significantly. The results of regression analysis of triglyceride subgroup showed that when triglyceride level was greater than or equal to 5.6 mmol/L, the risk of abnormal UACR level was significantly increased( P=0.029). Conclusion:Systolic blood pressure, triglyceride, HOMA-IR, and alcohol drinking history are independent risk factors for abnormal UACR in obese people. When systolic blood pressure is≥130 mmHg or triglyceride is≥5.6 mmol/L, the risk of abnormal UACR is significantly increased.

Elevated blood pressure increases risk of proliferative diabetic retinopathy: a Mendelian randomization study / 中华眼底病杂志

Objective:Mendelian randomization (MR) was used to analyze the potential relationship between blood pressure and proliferative diabetic retinopathy (PDR).Methods:Two-sample MR analysis was performed using summary statistics from genome-wide association studies. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were selected as the exposure, PDR as the outcome. The instrumental variable of SBP and DBP came from the publicly available data of the the UK Medical Research Council Comprehensive Epidemiology Unit and Neale Laboratory; the outcome data (8 681 cases in the case group, 204 208 cases in the control group, European population) are from the FinnGen database. Inverse variance weighting (IVW) and weighted median (WM) were used to analyze the potential relationships between SBP, DBP and PDR.Results:MR analysis showed that IVW [SBP: odds ratio ( OR)=1.36, 95% confidence interval ( CI) 1.17-1.57, P= 4.22E-05; DBP: OR=1.29, 95% CI 1.11-1.51, P=8.6E-04], WM (SBP: OR=1.33, 95% CI 1.07-1.66, P=0.009; DBP: OR=1.28, 95% CI=1.03-1.59, P=0.002). The results showed that elevated SBP and DBP increased the risk of PDR. Conclusion:Blood pressure (SBP, DBP) change is positively correlated with the risk of PDR.

Influencing Factors of Inter-arm Systolic Blood Pressure Differences in Hypertensive Population Aged 40 Years and Younger / 中国循环杂志

Objectives:To explore the influencing factors of inter-arm systolic blood pressure difference(sIAD)in young hypertensive population. Methods:A total of 12 895 young Kailuan employees aged≤40 years,who participated in the physical examination from 2010 to 2020,were enrolled in this study.All of them underwent blood pressure measurements of four limbs in supine position.Young hypertensive group(n=3 584)and young non-hypertensive group(n=3 584)were 1∶1 matched by sex and age(±1 year),and participants were further divided into sIAD＜10 mmHg(1 mmHg=0.133 kPa)and sIAD≥10 mmHg subgroups.A stepwise multivariate logistic regression model was established to analyze the determinants of sIAD≥10 mmHg. Results:The detection rate of sIAD≥10 mmHg was significantly higher in the young hypertensive group than in the young non-hypertensive group(31.72%vs.27.76%,P＜0.001).Stepwise multivariate logistic regression analysis showed that in young hypertensive population,ankle-brachial index(ABI)＜0.9,male,obesity,overweight,elevated low density lipoprotein cholesterol(LDL-C)level,and systolic blood pressure were positively associated with sIAD≥10 mmHg,while college education or above,physical exercise were negatively correlated with sIAD≥10 mmHg(all P＜0.05).In the young non-hypertensive population,ABI＜0.9,systolic blood pressure were positively correlated with sIAD≥10 mmHg,while age was negatively associated with sIAD≥10 mmHg(all P＜0.05). Conclusions:The detection rate of sIAD≥10 mmHg is higher in young hypertensive population than in young non-hypertensive population.Decreased ABI,male sex,obesity,overweight,increased LDL-C level,systolic blood pressure,college education and above,and physical exercise are the influencing factors of sIAD≥10 mmHg in young hypertensive population.

Effect of yoga on bio-physiological parameters among overweight and obese adolescents: a case series study

The number of overweight and obese children in India was 19.3% (NFHS-5), which was a big jump from the previous number of 6.3% (NFHS-4). A school-based case-series design was conducted to assess the effect of yoga on biophysiological parameters among overweight and obese adolescents (11-13 years) at selected schools in Puducherry. The census method was used to screen 286 adolescents, aged 11 to 13, for height and weight. The study included 18 overweight boys and girls. Bio-physiological parameters were measured at baseline, three months, and six months after yoga practice. The results of the study showed that a significant difference was found after yoga practice. The mean difference in weight reduction was 4.0, the BMI was 1.7, the waist circumference was 4.6, the hip circumference was 6.2, the triceps skin fold thickness was 4.9, and the sub capsular skin fold thickness was 5.7. The mean difference in pulse reduction was 8.8, the systolic blood pressure was 11.0, and the diastolic pressure was 6.9. In terms of body composition, the decrease in fat (%) was 3.4, water (%) was 2.4, extracellular volume (ECW) (%) was 1.1, intracellular volume (ICW) (%) was 2.0, and the body fat mass index (BFMI) was 1.7. The study concluded that yoga is effective in managing obesity and building healthy citizens in future adolescents.

ASSOCIATION BETWEEN BLOOD PRESSURE AND HAND GRIP STRENGTH AMONG ADULT POPULATION VISITING A TERTIARY CARE CENTRE – A CROSS–SECTIONAL STUDY

Introduction: It has been suggested that isometric handgrip resistance exercise be used as the first line treatment for hypertension. This cross-sectional study sought to better understand the association between adult individual's systolic and diastolic blood pressures with hand grip strength. The present study is a cross-s Methods: ectional study done among 240 healthy participants aged 19-40 years. Clearance was obtained from Institutional Ethical Committee. Blood pressure was recorded following standard precautions. The average of the maximum handgrip strength from both hands were taken into consideration. General linear models were used to examine the association between handgrip strength and blood pressure. Data was analyzed by Independent t test and Pearson correlation test using software, SPSS version 26. Handgrip strength was significantly and positively associated Results: with systolic blood pressure (P<0.001), diastolic blood pressure (P<0.001) and body mass Index (P<0.05). There was an increase in systolic blood pressure, diastolic blood pressure and body mass index with increase in handgrip strength. High systolic and diastolic blood pressures w Conclusion: ere associated with increased handgrip strength in both men and women. This aids in controlling blood pressure and might have implications for early prevention

Self-Measured Blood Pressure and Target Organ Damage in Newly Detected Hypertension in South Gujarat, India

Introduction: Blood pressure transient spikes have been considered to be noise and only a hindrance to a proper assessment of typical blood pressure, which is defined as the actual underlying average blood pres-sure over a long period of time. The current study aimed to see if the highest Self measured Systolic blood Pressure could be utilized to forecast the occurrence of Target organ damage and evaluate the independent association between the maximum Self measured Systolic blood Pressure and Target organ damage in indi-viduals with untreated hypertension. Method: We evaluated the urine albumin/creatinine ratio (UACR) and carotid intima-media thickness (IMT) using ultrasonography in 462 hypertensive individuals who had never taken treatment for their hypertension. Residential blood pressure was recorded. Result: The maximal Self measured Systolic blood Pressure had considerably higher association coefficients with left ventricular mass index (LVMI) and carotid intima-media thickness than the mean Self measured Sys-tolic blood Pressure. Irrespective of the mean Self measured Blood pressure level, multivariate regression studies showed that the maximal Self measured Systolic blood Pressure was independently related with left ventricular mass index and carotid intima-media thickness. Conclusion: Transiently high blood pressure measurements recorded at Self measured shouldn't be dis-missed as noise but rather taken seriously as significant warning signs of hypertensive Target organ damage in the heart and arteries.

Systolic blood pressure variation within a visit of community hypertension patients in Shanghai / 上海预防医学

ObjectivesTo investigate characteristics and influencing factors of short-term variation of systolic blood pressure of community hypertension patients in Shanghai. MethodsBased on the standardized blood pressure measurement data of hypertensive patients in Shanghai （2018‒2021） and the noninfectious chronic disease management system database， coefficient of variation of systolic blood pressure （CV_S） was described and the influencing factors were analyzed. ResultsAmong 112 680 community hypertension patients， males accounted for 46.87% with a median age of 69 years. CV_S was 0.038 6 ± 0.035 0. Generalized linear model analysis showed the following influencing factors of CV_S： gender， females were higher than males， B=0.032， P<0.001； age group， 60‒69 years， 70‒79 years old group， and ≥80 years groups were all higher than <50 years group， B=0.042， 0.056， and 0.074 respectively with P values of 0.020， 0.002， and <0.001 respectively； smoking， smoking cessation and smoking everyday was lower than never smoking， B=-0.032 and-0.028 respectively with P values of 0.023 and 0.007 respectively； systolic blood pressure， 140‒159 mmHg group， 160‒179 mmHg group， and ≥180 mmHg group were lower then <140 mmHg group， B=-0.039， -0.091， and -0.175 respectively with P values all <0.001； and measurement season， autumn was lower than spring， （B=-0.056， P<0.001）. The paired test showed that CV_S calculated from the three measurements was 1.04% higher than that calculated from the two measurements （P<0.001）. ConclusionThe coefficient of variation of systolic blood pressure of community hypertension patients in Shanghai has large variation， and was influenced by many factors.

Analyzing the results of finger systolic blood pressure tests in 28 healthy young adults / 中国职业医学

Objective To investigate the level of finger systolic blood pressure (FSBP) in healthy young adults. Methods A total of 28 healthy young adults were selected as the study subjects by convenient sampling method. The FSBP of the study subjects was detected at 30 and 10 ℃, and the FSBP index (Fi) was calculated. Results The FSBP of the study subjects at 30 and 10 ℃ were (102.0±16.5) and (104.4±15.2) mmHg, respectively. The FSBP in male group at 30 and 10 ℃ was (99.6±18.6) and (107.2±17.0) mmHg, respectively. The FSBP in female group at 30 and 10 ℃ was (104.4±13.9) and (101.5±2.8) mmHg, respectively. The results of factorial analysis showed that the interaction between gender and temperature on FSBP was statistically significant (P<0.05). FSBP in male group was higher at 10 than 30 ℃ (P<0.05) and higher than female group at 10 ℃ (P<0.05). There was no statistical significance for the main effect of gender, temperature, finger, or the interaction effect of gender and finger, temperature and finger for FSBP (all P>0.05). The average Fi of the study subjects was (98.0±16.6)%, with males and females having the average Fi of (100.7±20.7) % and (95.2±10.6) % respectively. The results of factorial analysis of variance showed that there was no significant difference on Fi in the main effect gender and fingers or the interaction effect between them(all P>0.05). Conclusion The FSBP test could be used as a detection method for assessing peripheral microcirculation function in Chinese population. However, further research is needed to establish reference ranges and influencing factors.

Correlations of systolic blood pressure with uric acid, blood lipid and blood glucose / 预防医学

Objective@#To analyze the correlations of systolic blood pressure (SBP) with uric acid, blood lipid and blood glucose in adults, so as to provide the evidence for blood pressure management and early prevention of cardiovascular diseases. @*Methods@# Based on the China Health and Nutrition Survey, data of participants in 2004 and 2009 was collected, including demographic characteristics, blood pressure, uric acid, blood lipid and blood glucose. Participants with SBP<140 mmHg both in 2004 and 2009 were divided into the continuously normal group, participants with SBP≥140 mmHg in 2004 and <140 mmHg in 2009 were divided into the reduced group, participants with SBP<140 mmHg in 2004 and ≥140 mmHg in 2009 were divided into the elevated group, and participants with SBP≥140 mmHg both in 2004 and 2009 were divided into the continuously high group. Multivariable logistic regression model was used to analyze the correlations of SBP with uric acid, blood lipid and blood glucose. @*Results@#A total of 5 086 subjects were included in this study with a mean age of (48.0±7.2) years, including 2 374 males (46.67%) and 2 712 women (53.33%). The median (interquartile range) of SBP was 117.00 (13.33) mmHg in the continuously normal group, 146.67 (15.33) mmHg in the reduced group, 122.67 (12.00) mmHg in the elevated group and 150.67 (18.66) mmHg in the continuously high group. Multivariable logistic regression analysis showed that compared with the continuously normal group, the reduced group was correlated with abnormal fasting blood glucose (OR=1.383, 95%CI: 1.008-1.896); the elevated group was correlated with abnormal uric acid (OR=1.495, 95%CI: 1.195-1.869), abnormal low density lipoprotein cholesterol (OR=1.226, 95%CI: 1.030-1.460), abnormal triglyceride (OR=1.446, 95%CI: 1.203-1.739) and abnormal total cholesterol (OR=1.261, 95%CI: 1.057-1.504); the continuously high group was correlated with abnormal uric acid (OR=1.603, 95%CI: 1.188-2.164), abnormal triglyceride (OR=1.619, 95%CI: 1.253-2.093) and abnormal fasting blood glucose (OR=1.565, 95%CI: 1.166-2.100), adjusting for confounding factors (gender, age, marital status, etc.).@*Conclusion@# The increase of SBP in adults were correlated with uric acid, blood lipid and blood glucose.

Disease burden of chronic kidney disease attributable to metabolic factors in Jiangsu Province in 1990 -2019 / 公共卫生与预防医学

Objective To analyze the burden of chronic kidney disease (CKD) attributable to metabolic factors in Jiangsu Province from 1990 to 2019, and to provide evidence for the formation and implementation of intervention policies. Methods Using data from Jiangsu Province from the 2019 Global Burden of Disease Study (GBD 2019), mortality and disability-adjusted life-years (DALYs) were selected as indicators for analysis and standardized with the age structure of the world standard population. The effects of three metabolic factors including high systolic blood pressure (SBP), high fasting glycaemic index (FPG) and high body mass index (BMI) on the disease burden of CKD were analyzed, and the attributable disease burden by gender and age was compared. Results The rank of the three attributable risk factors was high SBP, high FPG, and high BMI. Standardized mortality rates attributable to high SBP, high FPG, and high BMI all showed an overall upward trend from 1990 to 2019, with annual average percent changes (AAPCs) of 0.3%, 0.0%, and 2.8%, respectively. Age-standardized DALYs attributed to high SBP and high BMI showed increasing trends, with the AAPCs of 0.5% and 3.1% (both P＜0.05), respectively. There was no statistical significance of high FPG (P > 0.05). Mortality and disease burden attributed to high SBP both showed upward trends with increasing age. Age-standardized mortality and age-standardized DALYs attributed to high FPG peaked at 45-49 and 50-54 age-group, respectively. Both age-standardized mortality and age-standardized DALYs attributed to high BMI peaked at ages 60-64 age-group. Conclusion The trends of mortality and DALYs attributed to the three risk factors can reflect the changes of population structure and lifestyle in Jiangsu Province in the past 30 years to a certain extent. Early screening of population at high risk of CKD and targeted provision of health policies can reduce the mortality and disease burden of CKD.

Effect of isotonic exercise on cardiovascular parameters in medical students with parental history of hypertension – An institutional study

Background: Hypertension (HTN) is one of the most common and a high-risk factor for cardiovascular disease. Aims and Objectives: This study aims to identify students who are at risk of developing HTN with positive parental history of HTN and to compare the effects of isotonic exercise on cardiovascular parameters among the students with and without positive history of parental HTN. Materials and Methods: A total of 50 students participated in the study out of which 21 students had positive history of parental HTN with at least one parent having history of HTN and 29 students had negative history of parental HTN. Baseline pulse rate (PR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) of the participants were recorded. Then, all the participants performed Harvard step test for 3 min. The SBP, DBP, and PR were measured immediately after stopping the exercise and after 3 min and after 5 min of stopping the exercise. Data were statistically analyzed using unpaired t-test and ANOVA. P < 0.05 was considered statistically significant. Results: PR recorded after 3 min of stopping of exercise was significantly higher in the participants with positive parental history of HTN than the other group. SBP recorded immediately and after 3 min and after 5 min of stopping exercise was significantly higher in the participants with a positive history of parental HTN as compared to the other group. However, no statistically significant difference was observed in DBP between the two groups. Conclusion: Students with positive parental history may have relatively higher risk of developing HTN in future as an exaggerated blood pressure response to exercise was observed in them in this study.

Influence of examination stress on pulse rate and blood pressure in first MBBS students

Background: The term “stress” was first coined by the endocrinologist Hans Selye in the year 1930’s. Stress causes imbalance in the sympathetic and parasympathetic functions which can lead to disturbance in the body homeostasis. Medical education in India is vast, extensive and is more stressful. During undergraduate course medical students have to undergo many examinations such as internal assessment and university examinations, examination is one of the most common stressor for students. As performance in examinations determines the future of students, it is important for medical educators to know the prevalence, and causes, of stress among students at different time intervals. Aims and Objectives: The aim of the study was to study the influence of examination stress on 1st MBBS students of BRIMS, Bidar from there admission (no examination) to final university examination on blood pressure and pulse rate. Materials and Methods: The present study was conducted after obtaining the Ethical clearance from the institutional research and ethical committee of Bidar Institute of Medical Sciences, Bidar. The study is carried out in the department of Physiology, BRIMS, Bidar. Out of 150 1st year MBBS students, healthy 102 students aged 17 to 20 years were selected for the study after following the strict inclusion and exclusion criteria. After recording basic physical characteristics, Hemodynamic parameters such as Pulse Rate (Beats per minute), systolic blood pressure (SBP) (mmHg), and diastolic blood pressure (mmHg) were recorded in three sessions, 1st session 1 month after the admission, 2nd session 6–8 days before 1st internal assessment, and 3rd session 6–8 days before final university examinations. The values obtained were analyzed by using t-test. P < 0.05 was considered as statistically significant. Results: Results revealed that there was statistically significant increase in the values of pulse rate (bpm), SBP (mmHg), and diastolic blood pressure (mmHg) in the study subjects when non examination period (1st session) was compared with the values of before 1st internal assessment (2nd session) and before final university examination (3rd session). Conclusion: Thus our study concluded that the values of pulse rate, SBP, and diastolic blood pressure were observed to be higher before 1st internal assessment and before university examinations when compared with after 1 month of their admission to college (i.e., no examination time).

Prevalence of Obesity and Hypertension and its Associated Risk Factors among Chiru Females of Manipur

Background: Obesity and hypertension are two well-known public health issues associated with a very high risk of cardiovascular diseases worldwide. It has become increasingly prevalent with the advancing chronological age and developing of noncommunicable diseases such as hypertension, diabetes, cancer, and respiratory diseases. Objectives: The paper aims to determine the prevalence of obesity and hypertension and their associated risk factors among the Chiru females of Manipur. Methods: A cross-sectional study was conducted among 207 Chiru females of Manipur, whose ages ranged from 20 to 79 years. Anthropometric and blood pressure were measured using standard procedures. Statistical methods such as Chi-square, Pearson correlation, and odds ratio (OR) were employed. Results: The nutritional status of the overweight and the obese are 33.3% and 11.6%. The overall prevalence of high blood pressure was 22.2%. This study observed a significant Pearson correlation between blood pressure and body mass index (BMI), age, physical activity, salt intake, smoking, and alcohol. The binary logistic regression, in terms of OR and coefficient of correlation, shows enough shreds of evidence that BMI and lifestyle factors are strongly associated and correlated with hypertension. Conclusion: The present study found a high prevalence of overweight and obesity among Chiru females, which might have contributed to the overall moderate prevalence of hypertension. Smoking, physical inactivity, and salt intake involve a significant risk of hypertension. Therefore, lifestyle has dramatically influenced the Chiru females of Manipur in terms of hypertension and obesity.

A comparative study of automated versus manual measurement of blood pressure in a tertiary care hospital

Background: Measurement of arterial blood pressure (BP) is one of the routine procedures performed both in outpatient and inpatient services of the hospital. Even though BP estimation is routinely done, its values are vital to assess the health status of the patients. Accurate recordings of BP can be estimated by adhering to all the precautions and instructions relating to the specific method employed for BP measurement. In recent years, many health-care setups are replacing the traditional manual BP apparatus with automated machines (digital) for BP estimation. Hence, there is a need to compare these two techniques in relation to their accuracy. Aims and Objectives: In a quest to replace manual mercury sphygmomanometers with automated machines, there is a need to see the reliability of automated machines of BP measurements especially which are currently available in India. Hence, the present study will help us to see the accuracy of automated machines by simultaneously comparing them with manual mercury sphygmomanometer. Materials and Methods: A total of around 224 patients which include 124 males and 100 females within the age group of 25–35 years are recruited for the study. Informed consent was taken from all the subjects. Institute ethical clearance was obtained before conducting the research study. Both manual and automated BP apparatus were used for BP recording. Results: The mean systolic BP (SBP) recorded in males using the mercury sphygmomanometer was found to be 113.19 ± 10.60 mmHg, 113.08 ± 10.08 mmHg, and 117.16 ± 11.14 mmHg, and the mean diastolic BP (DBP) was found to be 68.76 ± 8.34 mmHg, 70.50 ± 8.66 mmHg, and 72.69 ± 8.35 mmHg in sitting, standing, and recumbent postures, respectively. The mean SBP recorded using digital sphygmomanometer was found to be 113.90 ± 10.93 mmHg, 117.24 ± 10.23 mmHg, and 117.16 ± 11.14 mmHg and the mean DBP recorded was found to be to be 68.50±8.43 mmHg, 70.50 ± 8.66 mmHg, and 72.39±7.89 mmHg in sitting, standing, and recumbent postures, respectively. The difference between mean SBP and DBPs in males recorded using the two devices was found to be statistically insignificant. Similarly, the difference between mean SBP and DBP in females recorded using the two devices was not statistically significant. Conclusion: From the above results, it is concluded that there were no significant differences in recorded values of manual mercury sphygmomanometer and automated digital sphygmomanometer.

Comparative Efficacy of Hydrochlorthiazide and Chlorthalidone, used either alone or in Combination Therapy in Patients with Essential Hypertension in Tertiary Care Hospital of Uttrakhand

Aims : To study the comparative efficacy of Hydrochlorothiazide and Chlorthalidone, either used alone or in combination on Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Lipid Profile and Anthropometry. Methods : It was a Prospective, Randomised, Longitudinal study, where consecutive patients presenting to medicine Out Patient Department (OPD) and In Patient Department (IPD) were screened for essential hypertension based upon the JNC VII Guidelines. Those subjects who satisfy the inclusion and exclusion criterias were included in the study. These subjects were divided into four subgroups. Each patient was assessed for Blood Pressure (BP), Lipid profile, Anthropometry for a period of 180 days. Results : There was statistically significant reduction in both systolic blood pressure and DBP in both the groups over a period of 180 days. This trend was progressive during the observed period in both the groups till a stable state was reached. There was a greater reduction in the SBP in the chlorthalidone group as compared to the Hydrochlorothiazide group (P value 0.05). However, such trend was not observed on the DBP on the two groups. Over a six months follow up there was no change in the Lipid parameters either on the same group or while comparing the two groups. The body Anthropometry , especially waist Hip ratio and Body Mass Index also did not show any significant difference in the two groups( either used alone or in combination). Conclusion : Chlorthalidone was found to be a relatively more potent Anti-hypertensive on SBP when compared with Hydrochlorothiazide .Both these drugs failed to show any significant difference in the Lipid Profile and Anthropometry in a period of six months.

Isolated systolic hypertension in very elderly

Globally, hypertension is a common problem in the elderly, and its prevalence increases with increasing age. Isolated systolic hypertension (ISH) subset is more common in the very elderly population, and as the population ages, its prevalence will rise more and more. In the past, treatment of hypertension (HT) in the very elderly was controversial and either no treatment or complications of treatment risk overweigh the benefits observed. The inclusion of elders in various clinical trials has demonstrated a better understanding and rational approach toward optimal management of HT. Systolic blood pressure (BP) is more important in predicting adverse cerebrovascular outcomes and decline in renal function in elderly patients with ISH. Early detection, protection of target organs, correction of high BP will develop, promote, and corroborate healthy aging.

Predictive value of BAT score in the prognosis of patients with spontaneous intracerebral hemorrhage / 中华急诊医学杂志

Objective:To study the predictive value of BAT score for the prognosis of patients with spontaneous intracerebral hemorrhage (sICH).Methods:A retrospective analysis of 93 sICH patients in the Emergency Department of the Second Affiliated Hospital of Wannan Medical College from January 2018 to December 2020 was conducted, and the patients were classified into the good prognosis group ( n=34) and the poor prognosis group ( n=59) according to the Glasgow Outcome Score (GOS) 3 months after the discharge. Clinical data such as basic data of patients, admission vital signs, laboratory indicators, National Institute of Health stroke scale (NIHSS) score and BAT score and other clinical data of the two groups were compared. Multivariate logistic regression was used to analyze the risk factors affecting poor prognosis of sICH patients. The receiver operating characteristic (ROC) curve was drawn to analyze predictive value of BAT score for poor prognosis of sICH patients. Results:The admission systolic blood pressure, white blood cell count, hypertension complications, emergency BAT score and NIHSS score of patients in the poor prognosis group were significantly higher than those in the good prognosis group ( P<0.05). Multivariate logistic regression analysis indicated that the admission systolic blood pressure ( OR=1.024, 95% CI: 1.002~1.046, P=0.035) and emergency BAT score ( OR=2.640, 95% CI: 1.445-4.825, P=0.002) could accurately predict the poor prognosis of sICH patients. ROC curve analysis showed that the area under ROC curve (AUC) of BAT score was 0.792, the sensitivity was 79.3%, and the specificity was 76.5%. The AUC of systolic blood pressure for predicting poor prognosis of sICH patients was 0.701, and the sensitivity was 55.2%, and the specificity was 88.2%. The AUC of BAT score combined with systolic blood pressure for predicting poor prognosis of sICH patients was 0.835. Conclusions:BAT score and admission systolic blood pressure could more accurately predict poor prognosis of sICH patients. The combination of them had a higher efficacy in predicting poor prognosis of sICH patients after 3 months.

Clinical study of endovascular recanalization in chronic Internal carotid artery occlusion patients under Hasan classification / 中风与神经疾病杂志

@#To explore the effectiveness and safety of endovascular recanalization for chronic internal carotid artery occlusion patients under Hasan classification.To evaluate the guiding value of Hasan classification for endovascular recanalization for chronic internal carotid artery occlusion.To investigate the effect of successful endovascular recanalization on systolic blood pressure.Methods We retrospectively reviewed 30 consecutive chronic internal carotid artery occlusion patients.According to Hasan classification and DSA results of our hospital，the study subjects were divided into 4 types：A，B，C and D.After admission，the rate of recanalization，perioperative complication and followup outcomes were collected.Results Among the 30 CICAO patients，83.3% were male and 16.7% were female，with an average age of （58.5±8.6） years.The success rate of endovascular recanalization in 30 patients was 63.3%.According to Hasan classification，the success rate of endovascular recanalization in type A was 81.8%，Type B 75%，Type C 50%，Type D 0%；The perioperative complications was 23.3%，9.1% for type A and 37.5% for type B，Type C 37.5%，Type D 0%，no severe stroke or death occurred during perioperative period.No related complications occurred in all patients during followup.There was statistical significance in systolic blood pressure before and after interventional recanalization in successful group （P<0.01）.There was no significant difference in preoperative and postoperative systolic blood pressure between the unsuccessful group of interventional recanalization （P>0.05）.Conclusion Interventional recanalization for CICAO patients is safe and effective according to Hasan classification criteria.This classification can screen patients suitable for interventional recanalization，predict the success rate of surgery.Successful interventional recanalization may result in a decrease in postoperative systolic blood pressure.

Correlation between serum trace elements and blood pressure in healthy people and patients with hypertension / 西安交通大学学报(医学版)

【Objective】 To explore the correlation between serum trace elements and systolic and diastolic blood pressure in healthy population and patients with hypertension. 【Methods】 The health examination data of the subjects from our hospital from September 2018 to May 2021 were selected. They consisted of 3430 healthy people with no history of chronic diseases and 216 patients with hypertension previously diagnosed. We measured the levels of serum zinc， iron， calcium， magnesium， lead， copper and cadmium and analyzed their correlation with systolic blood pressure （SBP） and diastolic blood pressure （DBP）. 【Results】 The incidence of low zinc （9.5%） and hypomagnesemia （1.8%） was relatively low， while hypomagnesemia （27.8%） was relatively common in the healthy population. Logistic regression analysis showed that age， BMI and serum albumin were associated with increased SBP and DBP. Fasting blood glucose （OR=1.095， 95% CI： 1.007-1.191） and blood lead （OR=1.006， 95% CI： 1.000-1.012） were risk factors for SBP. Serum total cholesterol （OR=1.244， 95% CI： 1.095-1.412）， serum iron （OR=1.275， 95% CI： 1.114-1.460） and blood lead （OR=1.010， 95% CI： 1.004-1.015） were risk factors， while serum magnesium （OR=0.488， 95% CI： 0.266-0.894） acted as a protective factor for DBP. After adjusting for age， gender， BMI， waist-hip ratio， and smoking history， there was no significant difference in serum trace element levels between the hypertension and healthy control groups. 【Conclusion】 SBP is correlated with serum lead， while DBP is positively correlated with serum iron and lead， but negatively correlated with serum magnesium in normal healthy population. There was no significant difference in serum trace element content between hypertensive patients and healthy control group， but the conclusion still needs to be further verified.

Importancia de estilos de vida en adultos mayores hipertensos: centro de adulto mayor "Renata Luque" 2019 / Importance of lifestyles in hypertensive older adults. Senior Center"Renta Luque". 2019

La Hipertensión Arterial es una enfermedad de etiología múltiple, caracterizada por la elevación persistente de la tensión arterial sistólica, diastólica o ambas cifras. Objetivo: Determinar los estilos de vida de los adultos mayores hipertensos del Centro del Adulto Mayor "Renta Luque" 2019. Siendo las variables del estudio estilos de vida el cual consta de tres dimensiones, nutrición, actividad física y hábitos nocivos. Materiales y métodos: La investigación se llevó a cabo mediante el método descriptivo de tipo cuantitativo. La muestra de este estudio se constituyó por 100 adultos mayores de ambos sexos con edades comprendidas entre los 60 y 80 años, con patología de base hipertensión arterial. Para conocer los estilos de vida se aplicó el cuestionario validado por expertos en metodología de investigación y especialistas médicos que consiste en 21 ítems de distintos criterios relacionados con el estilo de vida. Resultados: Con la información de los cuestionario se realizó un análisis, presentándose una síntesis gráfica de los resultados más relevantes de esta información. Los resultados de este estudio servirán como base para fomentar, con fundamentos reales, la práctica de actividad física, nutrición y los hábitos nocivos en la adquisición de hábitos saludables de la población nacional, generando el aporte para estudios posteriores sobre la relación de estas mismas variables en diversas poblaciones. Conclusión: Mantener un estilo de vida saludables es vital para garantizar la calidad de vida de este grupo etario. Es importante que cuenten con apoyo psicológico permanente, además de un estricto control nutricional, realización de ejercicios pasivos como yoga para evitar el alto nivel de stress que suelen presentar los adultos mayores en especial con comorbilidades como la hipertensión arterial(AU)

Arterial Hypertension is a disease of multiple etiology, characterized by persistent elevation of systolic blood pressure, diastolic blood pressure or both figures. Objective: To determine the lifestyles of hypertensive older adults at the "Renta Luque" Senior Center 2019. Being the variables of the study lifestyles that consists of three dimensions, nutrition, physical activity and harmful habits. Materials and methods: The research was carried out using the quantitative descriptive method. The sample of this study consisted of 100 older adults of both sexes aged between 60 and 80 years, with arterial hypertension. The questionnaire validated by experts in research methodology and medical specialists, consisting of 21 items of different criteria related to lifestyle, was applied to learn about lifestyles. Results: With the information from the results of the questionnaire, an analysis was made, presenting a graphic synthesis of the most relevant results of this information. The results of this study will serve as a basis to promote, with real foundations, the practice of physical activity, nutrition and harmful habits in the acquisition of healthy habits in the national population, generating the contribution for subsequent studies on the relationship of these same variables in different populations. Conclusion: Maintaining a healthy lifestyle is vital to ensure the quality of life of this age group. It is important that they have permanent psychological support, in addition to strict nutritional control and passive exercises such as yoga to avoid the high level of stress that older adults usually present, especially with comorbidities such as arterial hypertension(AU)