Blood Pressure最新文献

Objective: To determine the prevalence rate and risk factors for systemic arterial hypertension in infants with congenital heart diseases.

Methods: A retrospective cohort study of postoperative systemic arterial hypertension incidence in infants who underwent cardiac surgery was conducted. The primary diagnosis was retrieved. The general characteristics, surgical information, and blood pressure data at five periods were also collected. The five periods were at admission, 48 hours after cardiac surgery (postoperative), at discharge, at full-time, and at any time during hospitalisation. The risk factors for postoperative hypertension and hypertension at discharge were determined by multivariate logistic regression.

Results: This study enrolled 1205 eligible infants. The age and weight at surgery were 27.0 (13.0, 59.0) days and 3.53 ± 0.96 kg, respectively. The prevalence rates of postoperative hypertension and hypertension at discharge were 12.8 (10.9-14.7)% and 6.9 (5.5-8.3)%, respectively. The incidence of postoperative hypertension varies greatly across different types of congenital heart diseases. A low weight Z score, preoperative hypertension, patent ductus arteriosus, and coarctation of the aorta were risk factors for postoperative hypertension, whereas transposition of the great arteries grouped with pulmonary atresia, pulmonary stenosis, and total anomalous pulmonary venous connection was a protective factor. The ventricular septal defect was a risk factor for postoperative hypertension but not for hypertension at discharge.

Conclusions: The incidence of postoperative systemic arterial hypertension is high in infants after cardiac surgery. The prevalence of hypertension decreased at discharge. Prospective long-term follow-up studies are needed to delineate the natural history of hypertension in high-risk children.

Objective: This study investigates the relationship between hypertension, dysregulation of the autonomic nervous system, heart rate variability (HRV), and chronic inflammation.

Methods: We analysed a cohort of 50 hypertensive patients treated at the affiliated Hospital of Jianghan University. The average systolic and diastolic blood pressures (BPs) in this group were 155.26 and 95.32 mmHg, respectively. A control group of 50 healthy volunteers, undergoing routine physical examinations at the same hospital, was also analysed.

Results: The average systolic BP of the control group was 115.64 ± 10.27 mmHg, and the average diastolic BP was 75.33 ± 8.25 mmHg. In contrast, the experimental group exhibited an average systolic BP of 155.26 ± 20.13 mmHg and an average diastolic BP of 95.32 ± 12.16 mmHg. Both systolic and diastolic BPs were significantly higher in the hypertensive group (p < 0.05). The experimental group also demonstrated reduced HRV and skin conductance response, alongside increased BP variability (BPV), urinary epinephrine levels and prolonged pupillary light reaction time compared to controls (p < 0.05). Notably, Standard Deviation of Normal to Normal Intervals (SDNN) and Root Mean Square of Successive Differences (RMSSD) values were significantly lower in the experimental group (p < 0.05). Furthermore, levels of inflammatory markers such as CRP, TNF-α, IL-6 and IL-1β were markedly elevated in hypertensive patients (p < 0.05). Negative correlations were observed between systolic and diastolic BP with HRV metrics, while positive correlations were found between BP and BPV as well as urinary adrenaline levels.

Conclusions: The findings indicate that hypertension is closely associated with autonomic nervous system dysfunction, reduced HRV and increased chronic inflammation. A comprehensive approach to hypertension management should integrate these interrelated physiological and pathological mechanisms, with potential therapeutic interventions targeting autonomic function and inflammatory states.

Purpose: Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP.

Materials and methods: This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6-18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27-29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured.

Results: In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027).

Conclusions: These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.

Objectives: Evidence suggests that renal function increasingly deteriorates in patients with apparently treatment-resistant hypertension (ATRH) in comparison with those who have non-resistant arterial hypertension (NAH). We aimed to assess the long-term decline in renal function between these patient groups and identify specific risk factors contributing to the progression of renal dysfunction. Methods: Data for 265 patients with ATRH and NAH in a hypertension excellence centre were retrospectively evaluated. Demographic characteristics, co-morbidities, laboratory findings, secondary causes of hypertension, medication and exposure to contrast agents were assessed. To address differences between groups, adjustment with linear mixed-effect models was used. Results: Data from the first 4 years of follow-up were evaluated. After adjustment for age and diabetes, which were identified as independent risk factors for renal dysfunction progression in the study cohort, the mean decrease in estimated glomerular filtration rate per year was steeper with ATRH than with NAH (-1.49 vs. -0.65 mL/min/1.73 m² per year; difference in slope, 0.83 mL/min/1.73 m² per year; 95% confidence interval [CI]: 0.25-1.41, p = 0.005). In subgroup analyses, without Holm-Bonferroni correction, the prescription of MRA indicated a faster decline in renal function in ATRH. Following correction, no specific therapeutic risk factor was associated with faster progression of renal dysfunction. Conclusions: Renal function declines twice as fast with ATRH compared with NAH, independently of age and diabetes. Larger studies are needed to reveal risk factors for renal dysfunction in patients with hypertension.

Background: Carotid-femoral pulse wave velocity (cfPWV) and central pulse pressure (PP) are recognised as significant indicators of vascular health and predictors of cardiovascular outcomes. In this study, associations between central hemodynamics and left ventricular (LV) echocardiographic parameters were investigated in subjects with heart failure with reduced ejection fraction (HFrEF), comparing the results to healthy individuals.

Methods and results: This cross-sectional prospective controlled study included 50 subjects with HFrEF [mean LV ejection fraction (EF) 26 ± 6.5%] and 30 healthy controls (mean LVEF 65.9 ± 5.3%). Pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (cfPWV) were used to measure central hemodynamics and arterial stiffness. The HFrEF group displayed higher cfPWV (8.2 vs. 7.2 m/s, p = 0.007) and lower central (111.3 vs. 121.7 mmHg, p = 0.001) and peripheral (120.1 vs. 131.5 mmHg, p = 0.002) systolic blood pressure. Central pulse pressure (PP) was comparable between the two groups (37.6 vs. 40.4 mmHg, p = 0.169). In the HFrEF group, cfPWV significantly correlated with left ventricular end-diastolic volume (LVEDV) index (mL/m²) and LVEF, with LVEDV index being a significant independent predictor of cfPWV (R² = 0.42, p = 0.003). Central PP was significantly associated with heart rate, LVEF and LVEDV index, with the latter being a significant independent predictor of central PP (R² = 0.41, p < 0.001). These correlations were not observed in healthy controls.

Conclusions: Significant associations between central hemodynamic measures and LV echocardiographic parameters were identified, suggesting the potential to use PWA and cfPWV as possible tools for managing HFrEF.

Purpose: Despite dramatic medical advances over the last few decades, cardiovascular disease remains a leading cause of death globally. High BP is clearly established, but modifiable, risk factor for early disability and death. Although most of the adverse outcomes occur in adulthood it has become clear that high BP is a life course problem that can become evident in early life however, relatively little attention has been paid to the problem of high BP in children and adolescents. Materials and methods: Being aware of the problem and the needs, the Task Force of the ESH Guidelines in children and adolescents took the initiative to move forward in the field, identifying the COST Action program. A proposal, HyperChildNET, was submitted, approved and funded for 4 years starting in October 2020. Results: The aim of the Action has been to establish a European sustainable and multidisciplinary network of researchers, clinicians, early career investigators, health economists, decision-makers, regulatory bodies, and medical devices manufacturers under the umbrella of the European Commission in order to acquire a holistic understanding of those factors affecting high BP in children and adolescents in order to propose and implement preventive and corrective actions. All the activities carried out during the 4 years are described. Conclusions: HyperChildNET offers a European perspective of the issue giving us the opportunity to develop new strategies and objectives moving forward in the field.

George L. Bakris passed away on 15 June 2024 at the age of 72 years. This obituary aims at honouring his life and career by describing the stages in his personal and professional pathway, presenting some of his many remarkable accomplishments, and highlighting his exceptional clinical skills, mentorship, and friendship.