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2023 Challenges for the Management of Hypertension 2023高血压管理的挑战
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-04-01 DOI: 10.2174/157340211901230309162453
K. Kario
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引用次数: 0
Ca2+/cAMP Ratio as an Inflammatory Index. Ca2+/cAMP比值作为炎症指标。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666221202145753
Leandro Bueno Bergantin
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引用次数: 0
Cardiovascular Risk Related to Glomerular Hyperfiltration in Nondiabetic Individuals: Increasing Visibility is Crucial. 非糖尿病患者肾小球高滤过相关的心血管风险:提高能见度至关重要。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/0115734021268893231116045914
Rodolfo Valtuille

Glomerular hyperfiltration (GHF), defined by different estimation formulas, has been widely studied as a predictor of proteinuria and progression to chronic kidney disease (CKD) in diabetic patients. GHF is also an important cardiovascular (CV) risk factor and is related to allcause mortality in non-diabetic populations; however, the upper limit of glomerular filtration rate (GFR) above which it indicates the presence of GHF is weakly defined. This higher risk is as high as in the intermediate stages of CKD and is greater than the presence of diabetes or smoking and is still present in non-albuminuria patients. The original Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimation GFR formula showed lower error at higher glomerular filtration (GF) values, was the most used in population studies, and behaved as a better risk predictor. In our review (including approximately 3.6 million individuals), higher GFR values related to increased mortality risk varied from 106.6 to 113.7 ml/min, which are usually not considered risk values for standard guidelines in non-albuminuric patients. However, the lack of consensus on a GF cutoff value, as well as its variability due to sex and progressive reduction with age, affect the knowledge of this serious phenomenon in clinical practice. Although the elderly population is not exempted from the effects of GHF, the search for this phenomenon should be intensified in middle-aged populations because of their lower disease burden, where this situation may be more evident, and the possibility of reversing the consequences is greater. A population group often considered healthy includes obese people, essential hypertensives, smokers, and carriers of fatty liver, where the GHF phenomenon is frequent and is associated with CV disease, kidney disease, and higher mortality. Increasing its visibility by the medical community is essential to reduce the effects of GHF, emphasizing more frequent controls and implementing general measures that include strict control of hypertension, Na restriction, rich in vegetables diets and increased physical activity. Initiatives to confirm the beneficial effects of sodium-glucose cotransporter-2 inhibitors to treat isolated GHF would be an important breakthrough in reducing the severe consequences of this phenomenon.

肾小球高滤过(Glomerular hyperfiltration, GHF),由不同的估算公式定义,作为糖尿病患者蛋白尿和慢性肾脏疾病(CKD)进展的预测因子,已被广泛研究。GHF也是一个重要的心血管(CV)危险因素,与非糖尿病人群的全因死亡率有关;然而,肾小球滤过率(GFR)的上限没有明确的定义,高于该上限表明存在GHF。这种较高的风险与CKD中期一样高,比糖尿病或吸烟的存在更大,并且在非蛋白尿患者中仍然存在。原始的慢性肾脏疾病流行病学合作(CKD-EPI)估计GFR公式在较高的肾小球滤过率(GF)值时显示出较低的误差,在人群研究中使用最多,并且表现为更好的风险预测因子。在我们的综述中(包括大约360万人),与死亡风险增加相关的较高GFR值从106.6到113.7 ml/min不等,这通常不被视为非白蛋白尿患者标准指南的风险值。然而,由于缺乏对GF临界值的共识,以及其因性别和年龄而逐渐减少的可变性,影响了临床实践中对这一严重现象的认识。虽然老年人口不能免于GHF的影响,但应在中年人口中加强对这一现象的研究,因为他们的疾病负担较轻,这种情况可能更明显,扭转后果的可能性也更大。通常被认为健康的人群包括肥胖者、原发性高血压患者、吸烟者和脂肪肝携带者,在这些人群中,GHF现象经常发生,并与CV疾病、肾脏疾病和更高的死亡率有关。提高其在医学界的知名度对于减少GHF的影响至关重要,强调更频繁的控制和实施一般措施,包括严格控制高血压、限制钠、富含蔬菜饮食和增加身体活动。确认钠-葡萄糖共转运蛋白-2抑制剂治疗分离性GHF的有益作用的举措将是减少这一现象严重后果的重要突破。
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引用次数: 0
Sex-Specific Variations in Vitamin D and Vitamin D Binding Protein (Vdbp) and Flipped Pattern of their Association in Preeclamptic Women with Dyslipidemia. 维生素 D 和维生素 D 结合蛋白 (Vdbp) 的性别特异性变化及其与先兆子痫妇女血脂异常的反向关联模式
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230816090148
Kharb Simmi, Bhatotiya Chetna, Nanda Smiti, Gill Gurpreet

Background: Women with preeclampsia frequently have disorders of calcium metabolism during their pregnancies, including hypocalciuria and low vitamin D levels. The link between fetal sex and vitamin D and vitamin D binding protein levels in pregnancy and preeclampsia is not clear.

Aim: Present study was designed to explore sex-specific variations in vitamin D and vitamin D binding protein levels in maternal and umbilical cord blood samples for age and gestation matched 20 primigravida normotensive and 20 primigravida with preeclampsia with a singleton pregnancy.

Methods: Routine investigations, vitamin D binding protein (VDBP), and serum vitamin D in both maternal serum and cord blood were measured in both groups. Association between maternal and cord blood vitamin D levels was highly positive in both cases and control with babies of either sex.

Results: This association exhibited sexual dimorphism between cord blood vitamin D and vitamin D binding protein (VDBP) suggesting that the occurrence of pregnancy complications differs according to fetal sex with a higher cardiovascular and metabolic load for the mother in the presence of a male fetus.

Conclusion: Vitamin D binding protein (VDBP) measurement along with vitamin D level should be advised in clinical practice for early detection and screening.

背景:患有子痫前期的妇女在怀孕期间经常会出现钙代谢紊乱,包括低钙尿症和维生素D水平低下。目的:本研究旨在探讨与年龄和妊娠匹配的 20 名初产妇正常血压和 20 名初产妇子痫前期单胎妊娠的母血和脐带血样本中维生素 D 和维生素 D 结合蛋白水平的性别特异性变化:方法:对两组孕妇进行常规检查、维生素 D 结合蛋白 (VDBP) 以及母体血清和脐带血中的血清维生素 D 测量。结果:母体和脐带血维生素 D 水平之间的关系在病例和对照组男女婴儿中均呈高度正相关:结果:脐带血维生素 D 和维生素 D 结合蛋白(VDBP)之间的关联表现出性别二态性,这表明妊娠并发症的发生因胎儿性别而异,如果胎儿为男性,母亲的心血管和代谢负荷会更高:结论:临床实践中应建议在测量维生素 D 水平的同时测量维生素 D 结合蛋白 (VDBP),以进行早期检测和筛查。
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引用次数: 0
Minimal Contribution of the Social Determinants of Health to the Prevalence of Hypertension among Egyptian Public Servants. 健康的社会决定因素对埃及公务员高血压患病率的最小贡献。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230302090924
Ehab Salah Eshak, Nashwa Nabil Kamal, Nashaat Nabil Kamal

Background: Previous research suggests the role of social determinants of health (SDH) in the prevalence of hypertension.

Objective: The study aimed to estimate the contribution of SDH to the prevalence of hypertension.

Methods: We recruited 3072 Egyptian public servants who answered a self-administered questionnaire, including hypertension history. We measured the participants' blood pressure with standardized procedures. The logistic regression models were used to assess the associations between SDH and hypertension.

Results: The prevalence of hypertension was 28.2% (34.2% in males and 22.5% in females). The prevalence of undiagnosed hypertension was 16.3% (23.9% and 9.2%, respectively); thus, 57.8% of the hypertensive subjects were unaware of their high blood pressure status. SDH were associated with the odds of having hypertension in the unadjusted analyses. Higher education, being single, and having minor family members were associated with low odds of hypertension. On the other hand, non-professional occupations, job hours, household income, total family members, and work-family conflicts were associated with higher odds of hypertension. However, in the multivariable analyses, which included all SDH and adjusted for age, gender, smoking, physical activity, body mass index, medical history of chronic diseases, and family history of hypertension, only job hours were associated with the odds of having hypertension and undiagnosed hypertension: odds ratio (95% CI) = 1.07 (1.01-1.14) and 1.11 (1.02-1.20), respectively.

Conclusion: SDH contributed minimally to the odds of having hypertension among public officials in Minia, Egypt. Civil servants with long working hours should be tracked with regular blood pressure monitoring as a high-risk group for hypertension.

背景:先前的研究表明,健康的社会决定因素(SDH)在高血压患病率中的作用。目的:本研究旨在评估SDH对高血压患病率的贡献。方法:我们招募了3072名埃及公务员,他们回答了一份自我管理的问卷,包括高血压病史。我们用标准程序测量了参与者的血压。逻辑回归模型用于评估SDH与高血压之间的相关性。结果:高血压患病率为28.2%(男性34.2%,女性22.5%)。未确诊的高血压患病率为16.3%(分别为23.9%和9.2%);因此,57.8%的高血压受试者不知道自己的高血压状况。在未经调整的分析中,SDH与患高血压的几率相关。受过高等教育、单身和有未成年家庭成员与患高血压的几率较低有关。另一方面,非专业职业、工作时间、家庭收入、家庭成员总数和工作与家庭冲突与高血压的发病率较高相关。然而,在包括所有SDH并根据年龄、性别、吸烟、体育活动、体重指数、慢性病病史和高血压家族史进行调整的多变量分析中,只有工作时间与患有高血压和未确诊高血压的几率相关:比值比(95%CI)分别为1.07(1.01-1.14)和1.11(1.02-1.20)。结论:在埃及米尼亚,SDH对公职人员患高血压的几率影响最小。工作时间长的公务员应作为高血压的高危人群进行定期血压监测。
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引用次数: 0
Isolated Natural Antioxidants as a new Possible Therapeutic Alternative for the Treatment of Hypertension. 分离的天然抗氧化剂作为治疗高血压的一种新的可能的治疗选择。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402118666221003095317
Matheus Vinicius Barbosa da Silva, Maria Alessandra da Silva Lima, Lizandra Henrique de Farias, Vanessa Maria Dos Santos, Thyago Moreira de Queiroz

Oxidative stress is one of the main mechanisms involved in the pathophysiology of arterial hypertension, inducing direct effects on the vasculature, and contributing to endothelial dysfunction and consequent impairment of vascular relaxation. Despite a large number of pharmacological treatments available, intolerable side effects are reported, which makes the use of natural antioxidants a promising and complementary alternative for the prevention and treatment of hypertension. From this perspective, the current review aims to investigate and characterize the main antioxidants of natural origin for the treatment of hypertension. Antioxidants act in the inhibition or extinction of chemical reactions involving free radicals and consequently reduce the occurrence of damage caused by these cellular components. The main natural antioxidants for treating hypertension include caffeic acid, ferulic acid, curcumin, apocynin, quercetin, lipoic acid, and lycopene. The effects associated with these antioxidants, which make them therapeutic targets for decreasing high blood pressure, include increased activation of antioxidant enzymes, stimulation of nitric oxide bioavailability, and reduction in angiotensin-converting enzyme activity, arginase, and NADPH oxidase, whose effects contribute to reducing oxidative stress, improving endothelial function, and preventing cardiovascular dysfunctions. Thus, several products with antioxidant properties that are available in nature and their application in the treatment of hypertension are described in the literature. The therapeutic effects of these products seem to regulate several parameters related to arterial hypertension, in addition to combating and preventing the deleterious effects related to the disease.

氧化应激是参与动脉高血压病理生理的主要机制之一,诱导对血管系统的直接影响,并导致内皮功能障碍和随之而来的血管舒张损伤。尽管有大量可用的药物治疗,但难以忍受的副作用被报道,这使得使用天然抗氧化剂成为预防和治疗高血压的一个有前途的补充选择。从这个角度来看,本综述旨在研究和描述天然来源的主要抗氧化剂,以治疗高血压。抗氧化剂的作用是抑制或消除涉及自由基的化学反应,从而减少由这些细胞成分引起的损伤的发生。治疗高血压的主要天然抗氧化剂包括咖啡酸、阿魏酸、姜黄素、罗布麻素、槲皮素、硫辛酸和番茄红素。与这些抗氧化剂相关的作用,使其成为降低高血压的治疗靶点,包括增加抗氧化酶的激活,刺激一氧化氮的生物利用度,降低血管紧张素转换酶、精氨酸酶和NADPH氧化酶的活性,其作用有助于减少氧化应激,改善内皮功能,预防心血管功能障碍。因此,文献中描述了几种具有天然抗氧化特性的产品及其在高血压治疗中的应用。这些产品的治疗效果似乎调节了与动脉高血压有关的几个参数,除了对抗和预防与疾病有关的有害影响。
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引用次数: 0
The Effect of Bisoprolol on Premature Ventricular Complex in Vietnamese Patients with Hypertension and Left Ventricular Hypertrophy. 比索洛尔对越南高血压左心室肥厚患者早衰心室复合体的影响。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230110101228
Son Kim Tran, Toan Hoang Ngo, Anh Thi Phuong Nguyen, Huyen Thi Ngoc Huynh, Cuong Tan Vo, Ngan Ngoc Bao Nguyen, Thang Hoang Nguyen, Minh Van Huynh

Background: Premature ventricular contraction (PVC) is a common arrhythmia that causes a large number of clinical symptoms, adversely impacts the quality of life, and can even initiate serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation. The incidence of premature ventricular contraction is higher in hypertensive patients, particularly if concomitant left ventricular hypertrophy (LVH) is present.

Objectives: This study was conducted on the characteristics of PVC in hypertensive patients with left ventricular hypertrophy and aimed to evaluate the effect of bisoprolol on PVC in Vietnamese patients with hypertension and LVH.

Materials and methods: We conducted a study to determine how bisoprolol potency affected PVC management in the group with both high blood pressure and LVH. We selected a convenient sample of all patients who came to the Medical Examination Department at the Can Tho University of Medicine and Pharmacy Hospital and met sampling criteria with hypertension, LVH on echocardiography, and PVC on 12-leads electrocardiogram. Over 2 years, we collected 76 patients who satisfied the above conditions. Out of which, 50 patients were indicated for management with bisoprolol, and 26 patients were excluded from the study, including 7 patients with asthma and 19 patients who had simple PVC on a 24-hour Holter ECG. Data were analyzed with SPSS version 22.

Results: Fifty patients participated in the study, of whom 70% were female. It is clear that palpitation was the most prevalent symptom (66%), and 38% of patients had complicated PVC (Lown III-V). When treating PVC with bisoprolol, 50% of patients achieved the treatment goal with a decrease in the number of PVCs of more than 70%, accompanied by symptom relief and eradication of dangerous PVCs. After 4 weeks of treatment, bisoprolol decreased the number of PVCs, heart rate, and blood pressure while also easing PVC-related symptoms (p < 0.05).

Conclusion: Low-dose bisoprolol effectively reduces the number of PVCs in hypertensive patients with LVH.

背景:室性早搏(PVC)是一种常见的心律失常,可引起大量临床症状,对生活质量产生不利影响,甚至可引发严重的心律失常,如室性心动过速或心室颤动。高血压患者室性早搏的发生率较高,尤其是伴有左心室肥厚(LVH)的患者。目的:研究高血压左室肥厚患者的PVC特点,探讨比索洛尔对越南高血压合并左室肥厚患者PVC的影响。材料和方法:我们进行了一项研究,以确定比索洛尔效力如何影响高血压和LVH组的PVC管理。我们选取了一组方便的样本,选取了所有到Can Tho University Medicine and Pharmacy Hospital医学检查科就诊并符合高血压、超声心动图LVH和12导联心电图PVC采样标准的患者。在2年多的时间里,我们收集了76例符合上述条件的患者。其中,50例患者适用比索洛尔治疗,26例患者被排除在研究之外,包括7例哮喘患者和19例24小时动态心电图显示单纯性PVC的患者。数据采用SPSS version 22进行分析。结果:50例患者参与研究,其中70%为女性。很明显,心悸是最常见的症状(66%),38%的患者合并了PVC (low III-V)。比索洛尔治疗PVC时,50%的患者达到治疗目标,室性早搏数减少70%以上,伴有症状缓解和危险室性早搏根除。治疗4周后,比索洛尔降低了室性早搏次数、心率和血压,同时也缓解了室性早搏相关症状(p < 0.05)。结论:小剂量比索洛尔可有效降低伴有LVH的高血压患者室性早搏次数。
{"title":"The Effect of Bisoprolol on Premature Ventricular Complex in Vietnamese Patients with Hypertension and Left Ventricular Hypertrophy.","authors":"Son Kim Tran,&nbsp;Toan Hoang Ngo,&nbsp;Anh Thi Phuong Nguyen,&nbsp;Huyen Thi Ngoc Huynh,&nbsp;Cuong Tan Vo,&nbsp;Ngan Ngoc Bao Nguyen,&nbsp;Thang Hoang Nguyen,&nbsp;Minh Van Huynh","doi":"10.2174/1573402119666230110101228","DOIUrl":"https://doi.org/10.2174/1573402119666230110101228","url":null,"abstract":"<p><strong>Background: </strong>Premature ventricular contraction (PVC) is a common arrhythmia that causes a large number of clinical symptoms, adversely impacts the quality of life, and can even initiate serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation. The incidence of premature ventricular contraction is higher in hypertensive patients, particularly if concomitant left ventricular hypertrophy (LVH) is present.</p><p><strong>Objectives: </strong>This study was conducted on the characteristics of PVC in hypertensive patients with left ventricular hypertrophy and aimed to evaluate the effect of bisoprolol on PVC in Vietnamese patients with hypertension and LVH.</p><p><strong>Materials and methods: </strong>We conducted a study to determine how bisoprolol potency affected PVC management in the group with both high blood pressure and LVH. We selected a convenient sample of all patients who came to the Medical Examination Department at the Can Tho University of Medicine and Pharmacy Hospital and met sampling criteria with hypertension, LVH on echocardiography, and PVC on 12-leads electrocardiogram. Over 2 years, we collected 76 patients who satisfied the above conditions. Out of which, 50 patients were indicated for management with bisoprolol, and 26 patients were excluded from the study, including 7 patients with asthma and 19 patients who had simple PVC on a 24-hour Holter ECG. Data were analyzed with SPSS version 22.</p><p><strong>Results: </strong>Fifty patients participated in the study, of whom 70% were female. It is clear that palpitation was the most prevalent symptom (66%), and 38% of patients had complicated PVC (Lown III-V). When treating PVC with bisoprolol, 50% of patients achieved the treatment goal with a decrease in the number of PVCs of more than 70%, accompanied by symptom relief and eradication of dangerous PVCs. After 4 weeks of treatment, bisoprolol decreased the number of PVCs, heart rate, and blood pressure while also easing PVC-related symptoms (p < 0.05).</p><p><strong>Conclusion: </strong>Low-dose bisoprolol effectively reduces the number of PVCs in hypertensive patients with LVH.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"19 1","pages":"42-51"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Effect of Physical Exercise on Cardiac Autonomic Modulation in Hypertensive Individuals: A Systematic Review and Meta-analysis. 体育锻炼对高血压患者心脏自主神经调节的影响:系统回顾与元分析》。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230803090330
Ayesha Miraj Abidi, Aqsa Mujaddadi, Shahid Raza, Jamal Ali Moiz

Background: Cardiac autonomic dysfunction is associated with hypertension and exercise training (ET) in healthy individuals is found to improve cardiac autonomic modulation (CAM). However, the effects of physical exercise on CAM in hypertensive individuals are under debate.

Objective: The aim of the review is to systematically evaluate the literature on the effects of physical exercise on CAM in hypertensive individuals and analyse comparative differences in the effects of exercise between hypertensive and normotensive individuals.

Methods: Electronic databases, such as Pubmed, PEDro, Scopus, and Web of Science, were systematically searched from inception up to February, 2022, evaluating the effect of ET on CAM either by heart rate variability (HRV), baroreflex sensitivity or heart rate recovery. Fifteen studies were included in the review. The risk of bias was assessed using the Cochrane risk of bias tool version 2 and the risk of bias in studies of intervention (ROBINS-I) tool. The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation approach. Ten studies were included in the quantitative analysis. The meta-analysis and sensitivity analysis were performed using review manager 5.4.1; publication bias was assessed using Jamovi 2.2.5 software.

Results: The qualitative analysis revealed low to moderate certainty of evidence for ET and moderate for aerobic training. For the effect of overall ET, the analysis revealed that the standardized mean differences (SMD) showed a significant effect of ET on HF (SMD 1.76, p = 0.04) and RMSSD (SMD 1.19, p < 0.0001) and a significant decrease in LF (SMD -1.78, p = 0.04). Aerobic training revealed nonsignificant improvement in HRV parameters. In the comparative analysis, ET did not show a significant difference in improvement between hypertensive and normotensive individuals.

Conclusion: This review suggests an improvement in CAM with physical exercise in hypertensive individuals, but the overall effect of ET in hypertensive individuals must be interpreted with caution as the robustness of the data is compromised in the sensitivity analysis of the trials. High-quality future trials focusing on different modes of ET interventions are needed to strengthen the findings of the present review.

背景:心脏自律神经功能失调与高血压有关,而对健康人进行运动训练(ET)可改善心脏自律神经调节(CAM)。然而,体育锻炼对高血压患者心脏自律调节的影响还存在争议:本综述旨在系统评估有关体育锻炼对高血压患者 CAM 影响的文献,并分析高血压患者和正常血压患者在锻炼效果方面的比较差异:方法:系统检索了 Pubmed、PEDro、Scopus 和 Web of Science 等电子数据库(从开始到 2022 年 2 月)中通过心率变异性 (HRV)、气压反射敏感性或心率恢复评估 ET 对 CAM 影响的文献。15 项研究被纳入综述。偏倚风险采用 Cochrane 第 2 版偏倚风险工具和干预研究偏倚风险(ROBINS-I)工具进行评估。证据的总体质量采用建议分级、评估、开发和评价方法进行评估。定量分析纳入了 10 项研究。使用 review manager 5.4.1 进行了荟萃分析和敏感性分析;使用 Jamovi 2.2.5 软件评估了发表偏倚:定性分析显示,ET和有氧训练的证据确定性分别为中低。对于整体 ET 的效果,分析显示标准化平均差(SMD)显示 ET 对高频(SMD 1.76,p = 0.04)和 RMSSD(SMD 1.19,p < 0.0001)有显著影响,对低频(SMD -1.78,p = 0.04)有显著降低。有氧训练对心率变异参数的改善不明显。在对比分析中,ET 对高血压和正常血压人群的改善没有显示出明显差异:本综述表明,体育锻炼可改善高血压患者的 CAM,但必须谨慎解释 ET 对高血压患者的总体影响,因为试验的敏感性分析会影响数据的稳健性。今后还需要进行侧重于不同ET干预模式的高质量试验,以加强本综述的研究结果。
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引用次数: 0
Insight on Cardiac Chronobiology and Latest Developments of Chronotherapeutic Antihypertensive Interventions for Better Clinical Outcomes. 心脏时间生物学的见解和时间治疗性降压干预的最新进展,以获得更好的临床结果。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230109142156
Kumud Joshi, Madhubanti Das, Anupam Sarma, Mandeep K Arora, Manmohan SInghal, Bhavna

Cardiac circadian rhythms are an important regulator of body functions, including cardiac activities and blood pressure. Disturbance of circadian rhythm is known to trigger and aggravate various cardiovascular diseases. Thus, modulating the circadian rhythm can be used as a therapeutic approach to cardiovascular diseases. Through this work, we intend to discuss the current understanding of cardiac circadian rhythms, in terms of quantifiable parameters like BP and HR. We also elaborate on the molecular regulators and the molecular cascades along with their specific genetic aspects involved in modulating circadian rhythms, with specific reference to cardiovascular health and cardiovascular diseases. Along with this, we also presented the latest pharmacogenomic and metabolomics markers involved in chronobiological control of the cardiovascular system along with their possible utility in cardiovascular disease diagnosis and therapeutics. Finally, we reviewed the current expert opinions on chronotherapeutic approaches for utilizing the conventional as well as the new pharmacological molecules for antihypertensive chronotherapy.

心脏昼夜节律是身体功能的重要调节因子,包括心脏活动和血压。众所周知,昼夜节律紊乱会引发并加重各种心血管疾病。因此,调节昼夜节律可以作为心血管疾病的治疗方法。通过这项工作,我们打算从血压和心率等可量化参数的角度讨论目前对心脏昼夜节律的理解。我们还详细阐述了分子调节因子和分子级联,以及它们在调节昼夜节律方面的具体遗传方面,特别是对心血管健康和心血管疾病的参考。除此之外,我们还介绍了参与心血管系统时间生物学控制的最新药物基因组学和代谢组学标志物,以及它们在心血管疾病诊断和治疗中的可能用途。最后,我们回顾了目前关于利用传统和新的药物分子进行降压时间治疗的时间治疗方法的专家意见。
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引用次数: 0
Hemodynamic Changes after Continuing or Omitting Regular Angiotensin Converting Enzyme Inhibitors before Cataract Surgery: A Comparative Study. 白内障手术前继续使用或不使用常规血管紧张素转换酶抑制剂后的血流动力学变化:一项比较研究。
IF 2.3 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-01-01 DOI: 10.2174/1573402119666230112110328
Saeed Khademi, Reza Jouybar, Sedigheh Ahmadi, Naeimehossadat Asmarian, Maryam Ghadimi, Mehrdad Salari, Soodabeh Emami

Aims: In this study, we aimed to appraise the effects of interrupting (discontinuing) vs. continuing Angiotensin receptor blockers (ARBs) and Angiotensin-Converting Enzyme Inhibitors (ACEIs) on the hemodynamic changes of patients during and after cataract surgery.

Methods and materials: Patients aged 40-70 years, American society of anesthesiologist (ASA) class II, taking ACEI/ARB medications, who were admitted to Khalili hospital (Shiraz, South of Iran) for cataract surgery, were enrolled in the study. Patients were randomly divided into two groups for continuing or withdrawing the use of ACEI/ARBs. Group 1 included the patients who continued ACEI/ARB administration, and group 2 included those who discontinued them before surgery. In the operating room, relevant demographic information was collected in addition to the data on patients' basic clinical status, including heart rate and blood pressure, before induction of anesthesia, during, and after that. The collected data were analyzed using SPSS 21, and p-values < 0.05 were considered statistically significant.

Results: Any significant differences were not revealed in demographic variables (age, sex, diabetes, hypertension, Myocardial infarction, Smoking, and duration of drug therapy) between the two groups. Time effect was significant (p<0.001) for systolic blood pressure, diastolic blood pressure, and heart rate, and interaction between time*group was not significant (p = 0.431, p = 0.566, and p = 0.355) for systolic blood pressure, diastolic blood pressure, and heart rate. However, the group effect wasn't significant (p=0.701, p=0.663, and p=0.669) for systolic blood pressure, diastolic blood pressure, and heart rate.

Conclusion: It seems that in some minor surgeries, such as cataract surgery, withdrawal or continuation of ACEIs/ARBs have no significant effect on the hypotension and heart rate of patients during orafter an operation.

目的:在本研究中,我们旨在评估血管紧张素受体阻滞剂(ARBs)和血管紧张素转换酶抑制剂(ACEIs)对白内障手术期间和术后患者血流动力学变化的影响。方法和材料:年龄40-70岁,美国麻醉师学会(ASA) II级,服用ACEI/ARB药物,在Khalili医院(Shiraz, South of Iran)接受白内障手术的患者纳入研究。患者被随机分为两组继续或停止使用ACEI/ arb。组1包括继续服用ACEI/ARB的患者,组2包括术前停用ACEI/ARB的患者。在手术室中,除了收集患者在麻醉前、麻醉中、麻醉后的心率、血压等基本临床状况外,还收集了相关的人口统计信息。收集的数据采用SPSS 21进行分析,p值< 0.05为差异有统计学意义。结果:两组在人口统计学变量(年龄、性别、糖尿病、高血压、心肌梗死、吸烟、药物治疗持续时间)方面无显著差异。结论:在一些小型手术中,如白内障手术,停用或继续使用acei / arb对患者术中或术后低血压和心率无显著影响。
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引用次数: 0
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Current Hypertension Reviews
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