Blood Pressure最新文献

Purpose: It is not clear whether white-coat hypertension (WCH) is related to the development of left ventricular geometry changes in children.

Materials and methods: This retrospective, single-centre study categorised patients into obese and normal-weight groups. The obese cohort comprised 72 with hypertension (48 male, 12.3 ± 3.2 years), 40 with white-coat hypertension (WCH; 29 male, 12.9 ± 2.8 years) and 31 normotensive controls (18 male, 11.9 ± 2.2 years). The normal-weight cohort included 62 with hypertension (40 male, 12.9 ± 3.9 years), 32 with WCH (21 male, 12.5 ± 3.3 years) and 89 normotensive controls (60 male, 13.0 ± 2.1 years). Echocardiography and ambulatory blood pressure monitoring were performed for all participants with WCH or hypertension. Abnormal left ventricular geometry was defined as the presence of concentric remodelling, concentric left ventricular hypertrophy (LVH), or eccentric LVH.

Results: The prevalence of abnormal left ventricular geometry demonstrated a significant, stepwise increase from the control group to the WCH and hypertension groups among normal-weight children (1%, 9.4% and 25.8%, respectively; p < .001). This graded trend was absent in children with obesity, where the prevalence was elevated across all groups but did not increase progressively with the severity of the blood pressure phenotype (19.3%, 15% and 45.8%, respectively; p = .002).

Conclusion: These findings suggest that WCH may signify an intermediate cardiovascular risk state even in the absence of obesity. From a preventive medicine perspective, the identification of WCH in normal-weight children warrants periodic blood pressure monitoring. While our study clearly establishes the presence of this association in normal-weight youth, the specific nature of the interaction between WCH and obesity - whether additive or synergistic - warrants further investigation in larger, longitudinal cohorts.

Introduction: Fludrocortisone and midodrine are frequently used to raise blood pressure (BP) in patients with vasovagal syncope (VVS)/low BP phenotype and orthostatic hypotension (OH), despite limited supporting evidence. This study assesses changes in Ambulatory Blood Pressure Monitor (ABPM) biomarkers and symptoms of syncope after commencing/increasing fludrocortisone or midodrine.

Methods: Patients attending a tertiary-referral falls & syncope unit and prescribed fludrocortisone/midodrine were included. ABPM at index visit and follow-up (after commencing/increasing fludrocortisone/midodrine) were analysed, with specific focus on biomarkers of syncope risk: overall systolic BP (sBP), minimum sBP, and 'dips' in sBP <100 mmHg. Symptoms of presyncope and syncope were assessed at follow-up. These variables were compared pre and post medication changes using paired t-tests.

Results: 110 patient reviews (median age 57.0 (95%CI 46.4-63.8) years, 77% female) were followed for median 4.0 (IQR 2.0-8.0) months. Of these, 52% (57/110) commenced/increased fludrocortisone, and 48% (53/110) commenced/increased midodrine. Fludrocortisone use was associated with significant increases in overall sBP, minimum sBP and reduction in sBP dips <100mmHg. Symptoms of presyncope improved in 73.7% participants commencing/increasing fludrocortisone. Only 9/27 outcomes reached statistical significance in participants commencing/increasing midodrine: overall sBP increase commencing midodrine, overall sBP increase increasing midodrine (including subgroup ≥65 years), overall sBP increase commencing/increasing midodrine (including subgroup ≥65 years), minimum sBP increase commencing midodrine (including subgroup <65 years), decrease in sBP dips <100mmHg in subgroup aged ≥65 years increasing midodrine, and decrease in sBP dips <100mmHg in subgroup ≥65 years commencing/increasing midodrine. Symptoms of presyncope improved in 64.2% participants commencing/increasing midodrine.

Conclusion: This study provides clinical data on the effectiveness of fludrocortisone and midodrine in patients with VVS/low BP phenotype and OH. Both fludrocortisone and midodrine significantly improved markers of future syncope risk, with fludrocortisone use showing a relatively greater effect.

Objective: This study aimed to evaluate the effect of acupuncture on 24-hour ambulatory blood pressure (BP) and its circadian rhythm in patients with essential hypertension (EH).

Methods: A systematic search was conducted across five English databases (PubMed, the Cochrane Library, Embase, Web of Science, and The National Library of Medicine) and four Chinese databases (China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and VIP Chinese Science and Technology Journal Full-Text Database). The search period for each database was from inception to 31 May 2025. A meta-analysis was performed using RevMan 5.4.1 software.

Results: A total of 13 randomised controlled trials, involving 1,080 patients with EH, were included. The meta-analysis results showed that compared with the control group, the experimental (acupuncture) group demonstrated significantly lower values in the following parameters: 24-hour average systolic BP (SBP) (MD = -3.57, 95% confidence interval [CI]: -5.04 to -2.10, p < 0.001), 24-hour average diastolic BP (DBP) (MD = -3.61, 95% CI: -5.12 to -2.10, p < 0.001), 24-hour SBP variability (MD = -1.15, 95% CI: -1.57 to -0.73, p < 0.001), 24-hour DBP variability (MD = -0.96, 95% CI: -1.27 to -0.65, p < 0.001), 24-hour SBP load (MD = -3.47, 95% CI: -5.76 to -1.17, p = 0.003) and 24-hour DBP load (MD = -2.20, 95% CI: -4.08 to -0.31, p = 0.02).

Conclusion: Compared with Western medication alone, acupuncture combined with Western medication shows significant advantages in improving ambulatory BP parameters, including 24-hour average BP, 24-hour BP variability, 24-hour BP load, and the BP circadian rhythm.

Purpose: Poor adherence to antihypertensive treatment is one of the leading causes of life-threatening complications in individuals with hypertension. Therefore, investigating the factors involved is essential. This study aimed to identify sociodemographic factors, comorbidities, and biochemical parameters associated with poor adherence to antihypertensive treatment among university employees in southeastern Mexico.

Methods: A total of 259 hypertensive employees were included and grouped according to their level of adherence-high, moderate, or poor-using the MMAS-8 Scale. For group comparisons, the Kruskal-Wallis and χ² tests were used for continuous and categorical variables, respectively. To quantify the strength of these associations, a univariate binary logistic regression was performed, considering those variables that were significant in the preliminary comparative analyses. Additionally, to reinforce these observations, receiver operating characteristic (ROC) curves were constructed to evaluate the discriminative ability of biochemical parameters significantly associated with treatment adherence.

Results: A higher prevalence of hypertensive employees with low educational and occupational status was observed in the poor-adherence group, with obesity and dyslipidaemia being the most frequent comorbidities among them. Elevated blood glucose, uric acid, and lipid levels were also significantly associated with poor adherence (p < 0.001).

Conclusions: Educational institutions and healthcare systems should pay special attention to this working population, including, among other measures, medical follow-up, periodic monitoring of biochemical parameters, and the implementation of lifestyle changes.

Aim: This systematic review study aimed to discuss about the possibility role of epigenetic in HTN of children and adolescent.

Material and methods: This evidence-based research is implemented within the scope of the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) 2020. The data were analyzed qualitatively to assess the risk of bias, with the New Ottawa Scale (NOS) and Agency for Health Research and Quality (AHRQ) criteria as the thresholds. Our research highlights in particular showed that there is a role for epigenetics in HTN in children and adolescents.

Conclusion: Fourteen journals were included to be qualitatively assessed. Eleven journals (78.5%) stated that there was a correlation between epigenetic and BP in children and adolescents, however each study examined different genes or loci. In summary, epigenetic modifications of various single nucleotide polymorphisms (SNPs) and other genes were associated with higher systolic and diastolic BP in children and adolescents.

Background: Maintaining intraoperative mean arterial pressure (MAP) is crucial for surgical safety in elderly hypertensive patients, but the optimal target remains unclear. This study evaluated the association between different intraoperative MAP ranges and postoperative stress responses and organ function.

Methods: We conducted a single-center retrospective cohort study of 368 elderly hypertensive patients undergoing surgery under general anaesthesia. Patients were categorised into three groups based on actual intraoperative MAP: 65-75 mmHg, 75-85 mmHg, and 85-95 mmHg. Postoperative stress markers (cortisol, C-reactive protein [CRP]) and organ function markers (cardiac, renal, neurologic) were analysed using routine perioperative data.

Results: Patients in the low MAP group (65-75 mmHg) showed the highest postoperative cortisol and CRP levels, indicating stronger stress responses, and were more likely to experience myocardial and renal impairment. The high MAP group (85-95 mmHg) had a slightly increased cardiac load. The moderate MAP group (75-85 mmHg) demonstrated a balanced profile, with lower stress levels and better preservation of cardiac and renal function. Neurologic injury markers (NSE, S100β) and the incidence of postoperative delirium showed no statistically significant differences among groups, though trends towards higher values were observed in the low MAP group.

Conclusion: Maintaining intraoperative MAP within 75-85 mmHg appears to reduce postoperative stress and preserve cardiac and renal function in elderly hypertensive patients. Neurologic outcomes did not differ significantly, but avoiding excessively low MAP may help minimise potential neurological risk.

Background: Blood Pressure Variability (BPV) is an independent risk factor for cardiovascular events. Short-term indices of BPV, such as standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and Time Rate Index (TRI) are calculated using blood pressure (BP) measurements from 24-hour ambulatory blood pressure monitoring (ABPM). Although these indices have distinct units and amplitudes, their relationships have not been thoroughly investigated. This study aims to explore the correlation between the SD, CV, ARV, and TRI indices of short-term BPV.

Methods: Data were collected during the baseline evaluation of hypertensive participants with obstructive sleep apnoea in a randomised controlled trial. Systolic BPV indices were measured using 24-hour systolic ABPM. Pearson correlation (r) and intraclass correlation (ICC) for consistency were calculated among the BPV indices.

Results: Sixty-five participants aged ≥40 years were evaluated. SD, CV, and ARV showed high linear correlations, and their ICCs indicated moderate consistency between SD and CV, and between CV and ARV. In contrast, TRI exhibited weak correlations and no ICC consistency with the other indices.

Conclusions: The strong linear correlations and moderate-to-high ICC consistency among SD, CV, and ARV suggest these indices may be used interchangeably in studies of short-term BPV and cardio-vascular outcomes. TRI, however, reflects a distinct construct and should be evaluated separately when assessing its prognostic value.