External counterpulsation stimulation combined with acupuncture for vascular endothelial function in patients with hypertension: A randomized pilot trial.

OBJECTIVE: Endothelial function may improve with enhanced external counterpulsation (EECP) or acupuncture. This study aimed to evaluate the feasibility of acupoint stimulation combined with EECP (acupoint-EECP) for endothelial cell function in patients with essential hypertension. METHODS: Thirty essential hypertensive patients were, randomly divided into two groups, with 15 patients in the acupoint-EECP group, and 15 patients in the control group, of which 3 cases were lost by week 6. Both groups were treated with continued medicine. The participants in the acupoint-EECP group received acupoint stimulation combined with EECP therapy, 45 min for each time, 5 times weekly for 6 weeks for a total of 22.5 hours. The selected acupoints are Zusanli (ST36), Fenglong (ST40) and Sanyinjiao (SP6). The curative effects of the two groups were compared. RESULTS: The acupoint-EECP group (n=15) showed significant improvement in endothelial function [nitric oxide (NO) ，endothelin-1 (ET-1) and carotid-femoral pulse wave velocity (cf-PWV), respectively] values compared to the control group (n=12). Multiple imputation (n = 20 imputations) was performed to account for potential bias due to missing data. In stratified analyses, SBP and DBP values decreased when the baseline SBP was ≥120 mmHg and DBP was ≥80 mmHg. CONCLUSIONS: These findings suggest the feasibility of acupoint-EECP in improving endothelial function and treating hypertension. (The Chinese clinical trial registration number is ChiCTR2100053795.).

High Pulse Pressure Decreases Cardiopulmonary Ability among Older Chinese Patients with Primary Hypertension.

There is limited information regarding the reference values for cardiopulmonary exercise testing (CPX) variables in patients with primary hypertension. Our aim was to provide such values. In this single-center, retrospective study, we included 635 patients (male, 53.7%; mean ± standard deviation age, 62.1 ± 12.6 years) who completed maximal ramp incremental CPX using cycle ergometry at the Rui An Hospital of Traditional Chinese Medicine from August 1, 2018, to December 31, 2021. The patients were classified into two groups based on pulse pressure (PP): (1) patients with a low PP ≤ 60 mmHg (n = 324) and (2) patients with a high PP > 60 mmHg (n = 311). Stepwise linear regression was used to fit the equations of the key CPX variables. CPX was self-interrupted owing to fatigue by 64.5% (low PP) and 72.0% (high PP) of patients (χ2 analysis, P = 0.05). The anaerobic threshold (AT) could not be determined in 3.7% and 7.7%, respectively (χ2 analysis, P = 0.038). Peak oxygen consumption (VO2), carbon dioxide production, ventilation/minute, work rate, and VO2 at the AT were associated with age, weight, and sex. Moreover, a high PP was associated with impaired anaerobic exercise ability, as indicated by the reduced peak VO2, peak VE, and absolute peak work rate. Compared with prior research of a healthy population, patients with primary hypertension in this study exhibited impaired cardiopulmonary ability both at rest and during exercise, especially in the high PP group. The reference values and predictive equations for CPX variables provide a framework for interpreting the response to maximal ramp incremental cycle ergometry among older Chinese patients with primary hypertension.

Task switching in old participants: A potential interplay between strategy and cognitive ability.

Task-switching cost is highly reliable in old participants. However, in a Stroop-switching paradigm that compared old musicians with old non-musicians (Experiment 1A), task-switching costs were not consistent. For non-musicians, the task-switching costs were significant in the congruent and neutral trials, but not in the incongruent trials. For musicians, the task-switching costs disappeared completely. We suspected that besides following task rules, old participants might also apply a stimulus-based strategy called the target-first strategy. In Experiment 1B and 2, participants in Experiment 1A were invited again to perform two more Stroop-switching paradigms. To encourage the participants to use task rules, in Experiment 1B we removed the neutral trials but found the same results as in Experiment 1A. In Experiment 2, when inserting a cue-target interval in the Stroop-switching paradigm, both musicians and non-musicians produced reliable task-switching costs in all trial conditions. Note that younger participants had reliable task-switching costs in Experiment 1B and 2. We suggest that older participants preferred the target-first strategy to the task rules-based strategy because the former was easy to implant although it was less flexible. Besides task-switching costs, we found that old musicians had less interference effect than old non-musicians in Experiment 1B. In all three experiments, old musicians had shorter RTs than old non-musicians, which might be due to differences in strategies apart from cognitive abilities. We propose that without considering the strategy preference, some previous studies might misestimate the difference between old and young participants in terms of task-switching performance and interference control.