Pub Date : 2021-12-31DOI: 10.23937/2474-3690/1510064
Eng Franco Pessana, Sánchez Ramiro, Lev Gustavo, Mirada Micaela, M. Oscar, Ramírez Agustin, Fischer Edmundo Cabrera
Introduction: It has been demonstrated that the noninvasive evaluation of aortic blood pressure has a prognostic value but limited by the inaccuracy linked to technical errors and a differences in the pressure wave analysis. Aims: The aim of this study was to compare two methods used to validate the non-invasively central blood pressure waveforms obtained with an oscillometic device, with those recorded by intra-arterial measurements at the aortic level. Methods: In this study were included 20 subjects, 10 males (68 ± 12-years-old, BMI: 27.4 ± 4.6 Kg/m2) and 10 females (77 ± 8-years-old, BMI: 28.5 ± 5.3 Kg/m2). The analysed cohort was composed of patients with diagnosis of coronary artery disease. Invasive and non-invasive data used in this research were previously analysed using a widely reported methodology and published by our group. The invasive aortic pressure recording was synchronically acquired with an oscillometric brachial acquisition and, then a reconstruction of central pressure wave was performed. In this research a correlation analysis using the entire aortic pressure cycle was performed. Results: Coefficient values found of the whole population, using the entire aortic pressure cycle, were similar to those obtained using the mean value of the cBP cardiac cycle (0.88 versus 0.89; respectively). On the contrary, the slope of the regression line determined by invasive versus noninvasive cBP loops (n = 20) using the entire cBP cycle exhibit a remarkable decrease with respect to that obtained using the mean aortic pressure cycle (0.98 versus 0.77). Conclusions: In a first step, applying an interpolation procedure by means of oversampling and digital low pass filter, we found a high correlation between invasive and noninvasive instantaneous aortic pressure waveforms in: Men, women and the whole population, In a second step, results in terms of correlation coefficient and the slope derived from the regression analysis of invasive and non-invasive using a new data analysis allow to confirm high correlation coefficients and a more realistic slope value of the invasive versus non-invasive pressure wave relationship.
已有研究表明，无创主动脉血压评估具有预后价值，但由于技术错误和压力波分析的差异，其准确性受到限制。目的:本研究的目的是比较两种用于验证用振荡装置获得的无创中心血压波形和在主动脉水平动脉内测量记录的中心血压波形的方法。方法:本研究共纳入20例受试者，其中男性10例(68±12岁，BMI: 27.4±4.6 Kg/m2)，女性10例(77±8岁，BMI: 28.5±5.3 Kg/m2)。所分析的队列由诊断为冠状动脉疾病的患者组成。本研究中使用的侵入性和非侵入性数据先前使用广泛报道的方法进行了分析，并由我们小组发表。有创主动脉压力记录与振荡肱动脉采集同步，然后进行中央压力波重建。在这项研究中，使用整个主动脉压循环进行了相关分析。结果:使用整个主动脉压周期发现的整个人群的系数值与使用cBP心脏周期平均值获得的系数值相似(0.88 vs 0.89;分别)。相反，有创与无创cBP循环(n = 20)测定的整个cBP周期的回复线斜率与平均主动脉压周期测定的斜率相比显著降低(0.98对0.77)。结论:第一步，采用过采样和数字低通滤波器的插值方法，我们发现有创和无创瞬时主动脉压波形具有高度相关性:第二步，利用新的数据分析方法对有创和非创压力波进行回归分析，得到相关系数和斜率的结果，从而确定有创与非创压力波关系的高相关系数和更真实的斜率值。
{"title":"A New Approach to Validate the Use of Brachial Blood Pressure to Assess Non-Invasive Aortic Pressure in Human Beings","authors":"Eng Franco Pessana, Sánchez Ramiro, Lev Gustavo, Mirada Micaela, M. Oscar, Ramírez Agustin, Fischer Edmundo Cabrera","doi":"10.23937/2474-3690/1510064","DOIUrl":"https://doi.org/10.23937/2474-3690/1510064","url":null,"abstract":"Introduction: It has been demonstrated that the noninvasive evaluation of aortic blood pressure has a prognostic value but limited by the inaccuracy linked to technical errors and a differences in the pressure wave analysis. Aims: The aim of this study was to compare two methods used to validate the non-invasively central blood pressure waveforms obtained with an oscillometic device, with those recorded by intra-arterial measurements at the aortic level. Methods: In this study were included 20 subjects, 10 males (68 ± 12-years-old, BMI: 27.4 ± 4.6 Kg/m2) and 10 females (77 ± 8-years-old, BMI: 28.5 ± 5.3 Kg/m2). The analysed cohort was composed of patients with diagnosis of coronary artery disease. Invasive and non-invasive data used in this research were previously analysed using a widely reported methodology and published by our group. The invasive aortic pressure recording was synchronically acquired with an oscillometric brachial acquisition and, then a reconstruction of central pressure wave was performed. In this research a correlation analysis using the entire aortic pressure cycle was performed. Results: Coefficient values found of the whole population, using the entire aortic pressure cycle, were similar to those obtained using the mean value of the cBP cardiac cycle (0.88 versus 0.89; respectively). On the contrary, the slope of the regression line determined by invasive versus noninvasive cBP loops (n = 20) using the entire cBP cycle exhibit a remarkable decrease with respect to that obtained using the mean aortic pressure cycle (0.98 versus 0.77). Conclusions: In a first step, applying an interpolation procedure by means of oversampling and digital low pass filter, we found a high correlation between invasive and noninvasive instantaneous aortic pressure waveforms in: Men, women and the whole population, In a second step, results in terms of correlation coefficient and the slope derived from the regression analysis of invasive and non-invasive using a new data analysis allow to confirm high correlation coefficients and a more realistic slope value of the invasive versus non-invasive pressure wave relationship.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47113360","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}
Pub Date : 2021-12-31DOI: 10.23937/2474-3690/1510062
Adijat OLAYINKA Adeyosola, Folakemi Elizabeth, A.P. Adejumo, E. ATOLAGBE James
Diabetes mellitus is a silent killer and one of the leading causes of death globally. Its complications include damage to the brain, heart, kidney and the limbs. More than 50% of people living with the disease are oblivious to it especially in Nigeria where poor healthcare, unhealthy diet, sedentary lifestyle and poverty persist. Unfortunately, Civil Service workers in Osogbo, Osun States do not know their diabetic status. Hence, this study, seeks to determine the prevalence and risk factors of diabetes mellitus among Civil Service workers in Osogbo, Osun State, Nigeria. A descriptive study was conducted in selected ministries and agencies. Sampling was done using systematic sampling technique; an Agency/Ministry-based survey was carried out among 216 respondents who are Civil Service workers in Osogbo, Osun State using questionnaire forms. The sample size of 216 was determined by Cochran’s sampling formula. The questionnaire forms were administered to the Civil Service workers to obtain information about their bio-data, health status and lifestyle; measurements taken were also recorded in the questionnaire forms. Data obtained were analyzed using frequency, percentage, bar charts, and oneway analysis of variance (ANOVA), SPSS software, version 23. Findings of this study revealed a high prevalence of diabetes, due to the high incidence of high blood pressure and obesity, coupled with consumption of soft drinks, fatty parts of meat, fried meats, and family history of diabetes and blood pressure among the respondents.
{"title":"The Prevalence and Risk Factors of Diabetes Mellitus among Civil Service Workers in Osogbo, Osun State, Nigeria","authors":"Adijat OLAYINKA Adeyosola, Folakemi Elizabeth, A.P. Adejumo, E. ATOLAGBE James","doi":"10.23937/2474-3690/1510062","DOIUrl":"https://doi.org/10.23937/2474-3690/1510062","url":null,"abstract":"Diabetes mellitus is a silent killer and one of the leading causes of death globally. Its complications include damage to the brain, heart, kidney and the limbs. More than 50% of people living with the disease are oblivious to it especially in Nigeria where poor healthcare, unhealthy diet, sedentary lifestyle and poverty persist. Unfortunately, Civil Service workers in Osogbo, Osun States do not know their diabetic status. Hence, this study, seeks to determine the prevalence and risk factors of diabetes mellitus among Civil Service workers in Osogbo, Osun State, Nigeria. A descriptive study was conducted in selected ministries and agencies. Sampling was done using systematic sampling technique; an Agency/Ministry-based survey was carried out among 216 respondents who are Civil Service workers in Osogbo, Osun State using questionnaire forms. The sample size of 216 was determined by Cochran’s sampling formula. The questionnaire forms were administered to the Civil Service workers to obtain information about their bio-data, health status and lifestyle; measurements taken were also recorded in the questionnaire forms. Data obtained were analyzed using frequency, percentage, bar charts, and oneway analysis of variance (ANOVA), SPSS software, version 23. Findings of this study revealed a high prevalence of diabetes, due to the high incidence of high blood pressure and obesity, coupled with consumption of soft drinks, fatty parts of meat, fried meats, and family history of diabetes and blood pressure among the respondents.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48343771","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}
Pub Date : 2021-12-31DOI: 10.23937/2474-3690/1510065
Branch Ora Lee H, Rikhy Mohit, Auster-Gussman Lisa A, Lockwood Kimberly G, Graham Sarah A
{"title":"Changes in Blood Pressure and Body Weight in a Digital App-Based Hypertension Care Program Powered by Artificial Intelligence","authors":"Branch Ora Lee H, Rikhy Mohit, Auster-Gussman Lisa A, Lockwood Kimberly G, Graham Sarah A","doi":"10.23937/2474-3690/1510065","DOIUrl":"https://doi.org/10.23937/2474-3690/1510065","url":null,"abstract":"","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45315788","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}
Background: Hypertension is defined as two or more readings of systolic blood pressure measurement of 130 mmHg or higher or diastolic blood pressure measurement of 80 mmHg or higher. In the early stages, symptoms of hypertension (HTN) are often not detectable and thus many people with the disease are left undiagnosed. Undiagnosed HTN increases the risk of complications such as renal failure, myocardial infarction, heart failure, stroke and premature death. There is paucity of data concerning undiagnosed hypertension in southern Ethiopia. This study is aimed to assess prevalence of undiagnosed hypertension and its associated factors among adult peoples. Method: Community based Cross-sectional study design was conducted. English version questionnaire was used to collect data from 574 households. The data were collected and analyzed by SPSS version.23. The association between “blood pressure and socio-demographic characteristics’, life style factors, behavioral factors...” was tested by using multivariate logistic regression at P-value less than 0.05 and 95% CI. Result: Out of 574 participants, 108 (18.8%) of the study participants were current cigarette smokers and 143 (24.9%) were khat chewers. A sedentary lifestyle was seen in 106 (18.5%) of the studied people. Undiagnosed HTN was observed in 47 (15.3%) of the study participants. A total of 260 (45.3%) of respondents were identified as having undiagnosed hypertension. Body mass index (BMI), sedentary life style, cigarettes smoking, health seeking behavior, dietary habit and monthly income were significant predictors of undiagnosed HTN. Conclusion: Almost 50% of the adult population in the southern of Ethiopia shows undiagnosed hypertension and this is significantly correlated with body mass index (BMI), sedentary life style, cigarettes smoking, health seeking behavior, dietary habit and monthly income.
{"title":"Undiagnosed Hypertension and Its Associated Factors among Adult People Living in Southern Ethiopia: Evidence from Gunchire Woreda of Gurage Zone","authors":"Haligamo Demamu, Ayalew Abinet, Genemo Hilina, Yiriga Nega","doi":"10.23937/2474-3690/1510063","DOIUrl":"https://doi.org/10.23937/2474-3690/1510063","url":null,"abstract":"Background: Hypertension is defined as two or more readings of systolic blood pressure measurement of 130 mmHg or higher or diastolic blood pressure measurement of 80 mmHg or higher. In the early stages, symptoms of hypertension (HTN) are often not detectable and thus many people with the disease are left undiagnosed. Undiagnosed HTN increases the risk of complications such as renal failure, myocardial infarction, heart failure, stroke and premature death. There is paucity of data concerning undiagnosed hypertension in southern Ethiopia. This study is aimed to assess prevalence of undiagnosed hypertension and its associated factors among adult peoples. Method: Community based Cross-sectional study design was conducted. English version questionnaire was used to collect data from 574 households. The data were collected and analyzed by SPSS version.23. The association between “blood pressure and socio-demographic characteristics’, life style factors, behavioral factors...” was tested by using multivariate logistic regression at P-value less than 0.05 and 95% CI. Result: Out of 574 participants, 108 (18.8%) of the study participants were current cigarette smokers and 143 (24.9%) were khat chewers. A sedentary lifestyle was seen in 106 (18.5%) of the studied people. Undiagnosed HTN was observed in 47 (15.3%) of the study participants. A total of 260 (45.3%) of respondents were identified as having undiagnosed hypertension. Body mass index (BMI), sedentary life style, cigarettes smoking, health seeking behavior, dietary habit and monthly income were significant predictors of undiagnosed HTN. Conclusion: Almost 50% of the adult population in the southern of Ethiopia shows undiagnosed hypertension and this is significantly correlated with body mass index (BMI), sedentary life style, cigarettes smoking, health seeking behavior, dietary habit and monthly income.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42547181","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}
Background: Hypertension has been on high prevalence recently in developing countries of which Ghana is of no exception. Over the period, hypertension education has mostly been geared towards people who already have been diagnosed of the condition leaving most of the general population in the dark. This untargeted portion of the population tend to predispose themselves to the condition as they ignorantly involved themselves in high-risk activities. Method: A cross-sectional descriptive research design was adopted to conduct the study. Open and close ended, self-administered questionnaires were used to collect information on the social demographics, knowledge, attitudes and lifestyle on hypertension among respondents. Statistical Package for Social Sciences (SPSS) software was used to analyze the data. Results were presented in tables, bar graphs and pie chart. Results: The study showed that less than half (49.3%) of the respondents correctly explained that hypertension means increased force of blood through the blood vessels and 90.8% agreed that taking of antihypertensive medications can control hypertension. Also, the study showed that the majority of respondents (92.2%) identified exercising as an important factor in controlling hypertension and 32.7% responded yes to using herbal preparations to control their hypertension. Conclusion: The findings of the study provides information on knowledge, attitudes and lifestyle practices pertaining to hypertension among the people of Ahoe. Minority of the respondents had good knowledge on what hypertension was and very few of them were hypertensive.
{"title":"Knowledge, Attitude and Lifestyle Practices Pertaining to Hypertension among the People of Ahoe-Ho","authors":"Sefah Bernard, Onyame Addison, Ankrah Christopher, Adjetey Patrick Tetteh, Nutornutsi Mavis Deladem","doi":"10.23937/2474-3690/1510061","DOIUrl":"https://doi.org/10.23937/2474-3690/1510061","url":null,"abstract":"Background: Hypertension has been on high prevalence recently in developing countries of which Ghana is of no exception. Over the period, hypertension education has mostly been geared towards people who already have been diagnosed of the condition leaving most of the general population in the dark. This untargeted portion of the population tend to predispose themselves to the condition as they ignorantly involved themselves in high-risk activities. Method: A cross-sectional descriptive research design was adopted to conduct the study. Open and close ended, self-administered questionnaires were used to collect information on the social demographics, knowledge, attitudes and lifestyle on hypertension among respondents. Statistical Package for Social Sciences (SPSS) software was used to analyze the data. Results were presented in tables, bar graphs and pie chart. Results: The study showed that less than half (49.3%) of the respondents correctly explained that hypertension means increased force of blood through the blood vessels and 90.8% agreed that taking of antihypertensive medications can control hypertension. Also, the study showed that the majority of respondents (92.2%) identified exercising as an important factor in controlling hypertension and 32.7% responded yes to using herbal preparations to control their hypertension. Conclusion: The findings of the study provides information on knowledge, attitudes and lifestyle practices pertaining to hypertension among the people of Ahoe. Minority of the respondents had good knowledge on what hypertension was and very few of them were hypertensive.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46605871","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}
Pub Date : 2021-01-29DOI: 10.23937/2474-3690/1510055
Park Ha Eun, J. BillupsSarah, M. SchillingLisa
Background: The Dietary Approach to Stopping Hypertension (DASH) is considered first-line therapy for hypertension, yet clinical practice implementation remains suboptimal. Methods: We designed a survey to assess four domains: (1) Provider beliefs/knowledge of DASH benefits, (2) Patient characteristics influencing likelihood of recommendation, (3) Practice barriers to provision of DASH diet advice, and (4) Resources of perceived value. The survey was sent to University of Colorado School of medicine primary care providers practicing in the Denver metro area. Results: The survey was sent electronically to 149 providers, with 49 (33%) responders. Most (65%) believed DASH diet is as effective at lowering blood pressure as adding a medication. The most common patient and practice barriers influencing the decision to provide DASH dietary advice included perceived low patient motivation (90%) or ability (86%) to implement DASH diet, lack of provider time (71%), and lack of patient-directed educational resources (67%). Resources providers identified as useful included resources accessible through the electronic medical record, (88%), a dietician (83%), and printed patient-education materials (59%). Conclusion: Interventions to increase provision of DASH dietary advice should focus on identifying eligible patients, accessible and well-disseminated educational materials, and expanded access to evidence-based interventions involving dieticians.
{"title":"Physician Perceived Barriers and Solutions to DASH Diet Recommendations for Hypertension Prevention and Management","authors":"Park Ha Eun, J. BillupsSarah, M. SchillingLisa","doi":"10.23937/2474-3690/1510055","DOIUrl":"https://doi.org/10.23937/2474-3690/1510055","url":null,"abstract":"Background: The Dietary Approach to Stopping Hypertension (DASH) is considered first-line therapy for hypertension, yet clinical practice implementation remains suboptimal. Methods: We designed a survey to assess four domains: (1) Provider beliefs/knowledge of DASH benefits, (2) Patient characteristics influencing likelihood of recommendation, (3) Practice barriers to provision of DASH diet advice, and (4) Resources of perceived value. The survey was sent to University of Colorado School of medicine primary care providers practicing in the Denver metro area. Results: The survey was sent electronically to 149 providers, with 49 (33%) responders. Most (65%) believed DASH diet is as effective at lowering blood pressure as adding a medication. The most common patient and practice barriers influencing the decision to provide DASH dietary advice included perceived low patient motivation (90%) or ability (86%) to implement DASH diet, lack of provider time (71%), and lack of patient-directed educational resources (67%). Resources providers identified as useful included resources accessible through the electronic medical record, (88%), a dietician (83%), and printed patient-education materials (59%). Conclusion: Interventions to increase provision of DASH dietary advice should focus on identifying eligible patients, accessible and well-disseminated educational materials, and expanded access to evidence-based interventions involving dieticians.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42369904","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}
S. alhabardi, Maryam Aldhaefi, Mohammed Alessa, M. Alammari, Yousef A. Al-Rajhi, Rami Bustami
Background: Intradialytic hypotension (IDH) is the most common complication during hemodialysis procedure. Midodrine, an oral α-1 adrenergic agonist, is commonly used to prevent IDH. However, limited data is available to demonstrate midodrine effectiveness in prevention of IDH in high-risk hemodialysis patients. Objective: To describe the clinical outcomes of using midodrine in patients receiving hemodialysis concerning the incidence of IDH. Also, we aimed to explore the appropriate dose for midodrine use to prevent IDH. Methodology A retrospective cohort of adult with end-stage-renal failure. Exposure: Midodrine. Outcomes measure: IDH was defined as a decline in systolic blood pressure (SBP) by ≥20 mmHg or a decline in main arterial pressure (MAP) by ≥10 mmHg during hemodialysis session. Recurrent IDH was defined as three or more episodes of IDH throughout a year of starting midodrine. Analysis: A descriptive analysis of the frequency of IDH and recurrent IDH. We also, compared the risk of recurrent IDH across various doses of midodrine use. Result: From a total of 68-screened patients’ charts, 45 patients were included in the final analysis. 41.8% (n=28) of the study population had an IDH that required additional interventions to restore the SBP and MAP. IDH occurred in 68% (n=19, P=0.03) of patients with hypoalbuminemia. Recurrent IDH occurred in 36% (n=16) of the patients over their hemodialysis procedure. Incidence of treatment failure (57%, p= 0.02) and recurrent IDH (36%, p=0.04) were statistically significant in patients who received midodrine three time per week (57%) in comparison to those who received more than three days per week Conclusion: This exploratory study shows that a considerable proportion of patients receiving midodrine did not develop IDH or recurrent IDH. A long-term follow-up study with larger number of patients in comparison to the control group would be useful to evaluate the magnitude of efficacy of midodrine in hemodialysis patients with high risk for IDH. Moreover, a future prospective trial that focus on an important clinical outcomes such as cardiovascular events and mortality with midodrin is warranted.
{"title":"Midodrine for Prevention of Intradialytic Hypotension in High Risk Patients at a Tertiary Referral Hospital: A Retrospective Study","authors":"S. alhabardi, Maryam Aldhaefi, Mohammed Alessa, M. Alammari, Yousef A. Al-Rajhi, Rami Bustami","doi":"10.21203/rs.2.17325/v1","DOIUrl":"https://doi.org/10.21203/rs.2.17325/v1","url":null,"abstract":"\u0000 Background:\u0000Intradialytic hypotension (IDH) is the most common complication during hemodialysis procedure. Midodrine, an oral α-1 adrenergic agonist, is commonly used to prevent IDH. However, limited data is available to demonstrate midodrine effectiveness in prevention of IDH in high-risk hemodialysis patients.\u0000Objective:\u0000To describe the clinical outcomes of using midodrine in patients receiving hemodialysis concerning the incidence of IDH. Also, we aimed to explore the appropriate dose for midodrine use to prevent IDH.\u0000Methodology\u0000A retrospective cohort of adult with end-stage-renal failure.\u0000Exposure: Midodrine.\u0000Outcomes measure: IDH was defined as a decline in systolic blood pressure (SBP) by ≥20 mmHg or a decline in main arterial pressure (MAP) by ≥10 mmHg during hemodialysis session. Recurrent IDH was defined as three or more episodes of IDH throughout a year of starting midodrine.\u0000Analysis: A descriptive analysis of the frequency of IDH and recurrent IDH. We also, compared the risk of recurrent IDH across various doses of midodrine use.\u0000Result:\u0000From a total of 68-screened patients’ charts, 45 patients were included in the final analysis. 41.8% (n=28) of the study population had an IDH that required additional interventions to restore the SBP and MAP. IDH occurred in 68% (n=19, P=0.03) of patients with hypoalbuminemia. Recurrent IDH occurred in 36% (n=16) of the patients over their hemodialysis procedure. Incidence of treatment failure (57%, p= 0.02) and recurrent IDH (36%, p=0.04) were statistically significant in patients who received midodrine three time per week (57%) in comparison to those who received more than three days per week\u0000Conclusion:\u0000This exploratory study shows that a considerable proportion of patients receiving midodrine did not develop IDH or recurrent IDH. A long-term follow-up study with larger number of patients in comparison to the control group would be useful to evaluate the magnitude of efficacy of midodrine in hemodialysis patients with high risk for IDH. Moreover, a future prospective trial that focus on an important clinical outcomes such as cardiovascular events and mortality with midodrin is warranted.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42899416","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}
Pub Date : 2019-09-30DOI: 10.23937/2474-3690/1510043
Çakıcı Evrim Kargın, Şükür Eda Didem Kurt, YazılıtaŞ Fatma, G. Gökce, Güngör Tülin, Çelikkaya Evra, K. Deniz, Bülbül Mehmet
Background: The clinical significance of white coat hypertension is still uncertain. We aimed to evaluate children with white coat hypertension regarding their clinical, laboratory characteristics, evidence of target organ damage and compare them to normotensive and hypertensive children. Methods: Fourty patients diagnosed with white coat hypertension, 40 patients with primary hypertension and 40 normotensive children of similar age, gender and body mass index were included in the study. Ambulatory blood pressure monitoring and echocardiographic examination were performed to all children. Clinical and laboratory characteristics were noted. Results: All ambulatory blood pressure monitoring parameters, except night-time diastolic blood pressures and loads, were significantly higher in patients with white coat hypertension compared to normotensive ones. Left ventricular hypertrophy was 35% in the primary, 15% in the white coat hypertension group, and no left ventricular hypertrophy was detected in normotensive patients. No significant difference was found between 3 groups in terms of proteinuria or retinopathy. Conclusions: Children diagnosed with white coat hypertension had ambulatory blood pressure monitoring measurements and left ventricular mass index values smaller than patients with primary hypertension but more than normotensive children. Echocardiographic changes might suggest that white coat hypertension can be associated with target-organ damage.
{"title":"White Coat Hypertension in Children and Adolescents: Innocent or Not?","authors":"Çakıcı Evrim Kargın, Şükür Eda Didem Kurt, YazılıtaŞ Fatma, G. Gökce, Güngör Tülin, Çelikkaya Evra, K. Deniz, Bülbül Mehmet","doi":"10.23937/2474-3690/1510043","DOIUrl":"https://doi.org/10.23937/2474-3690/1510043","url":null,"abstract":"Background: The clinical significance of white coat hypertension is still uncertain. We aimed to evaluate children with white coat hypertension regarding their clinical, laboratory characteristics, evidence of target organ damage and compare them to normotensive and hypertensive children. Methods: Fourty patients diagnosed with white coat hypertension, 40 patients with primary hypertension and 40 normotensive children of similar age, gender and body mass index were included in the study. Ambulatory blood pressure monitoring and echocardiographic examination were performed to all children. Clinical and laboratory characteristics were noted. Results: All ambulatory blood pressure monitoring parameters, except night-time diastolic blood pressures and loads, were significantly higher in patients with white coat hypertension compared to normotensive ones. Left ventricular hypertrophy was 35% in the primary, 15% in the white coat hypertension group, and no left ventricular hypertrophy was detected in normotensive patients. No significant difference was found between 3 groups in terms of proteinuria or retinopathy. Conclusions: Children diagnosed with white coat hypertension had ambulatory blood pressure monitoring measurements and left ventricular mass index values smaller than patients with primary hypertension but more than normotensive children. Echocardiographic changes might suggest that white coat hypertension can be associated with target-organ damage.","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48909105","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}
Pub Date : 2019-08-05DOI: 10.23937/2474-3690/1510042
Afşin Abdulmecit, Asoğlu Ramazan, Kurtoğlu Ertuğrul, K. Hakan
Objective: Concentric or eccentric left ventricular hypertrophy (LVH) is an independent prognostic factor of major cardiovascular events in hypertension (HT). A high neutrophil to lymphocyte ratio (NLR) is correlated with high mortality and poor prognosis in cardiovascular disease. This study was performed to investigate the associations between NLR and different left ventricular (LV) geometric patterns in patients with newly diagnosed HT. Methods: The study population consisted of 222 patients with newly diagnosed HT (mean age: 53.2 ± 10.0 years). Echocardiographic examination was performed in all patients. Four different geometric patterns were determined in hypertensive patients according to the left ventricular mass index (LVMI) and relative wall thickness (RWT). Results: The baseline demographic characteristics were similar in all groups. The NLR and platelet to lymphocyte ratio (PLR) were higher in the eccentric hypertrophy and concentric hypertrophy groups compared to the normal geometry and concentric remodeling groups (p < 0.05, for all). NLR was positively and significantly correlated with LVMI (r = 0.508, p < 0.001). Linear regression analysis showed that LVMI was independently correlated with NLR (β = 5.440, p < 0.001), systolic blood pressure (β = 0.284, p < 0.001), ejection fraction (β = -0.201, p < 0.001), E/A (β = -2.270, p = 0.24), and high-density lipoprotein cholesterol (β = -0.245, p < 0.001). Conclusions: We demonstrated that patients with newly diagnosed HT with LVH had significantly higher NLR and PLR compared to those without LVH. In addition, NLR predicted LVH in hypertensive patients. The results of this study suggested that inflammation plays a role in the pathogenesis of LVH in hypertensive subjects. Original article *Corresponding author: Dr. Abdulmecit Afşin, Department of Cardiology, Adıyaman State Hospital, Adıyaman, Turkey, Tel: +90-537-721-66-73, Fax: +90-416725-65-02 1Department of Cardiology, Adıyaman State Hospital, Turkey 2Department of Cardiology, Training and Research Hospital, Turkey 3Department of Cardiology, Adıyaman University Faculty of Medicine, Turkey
{"title":"Neutrophil to Lymphocyte Ratio as a Predictor of Left Ventricular Hypertrophy in Patients with Newly Diagnosed Hypertension","authors":"Afşin Abdulmecit, Asoğlu Ramazan, Kurtoğlu Ertuğrul, K. Hakan","doi":"10.23937/2474-3690/1510042","DOIUrl":"https://doi.org/10.23937/2474-3690/1510042","url":null,"abstract":"Objective: Concentric or eccentric left ventricular hypertrophy (LVH) is an independent prognostic factor of major cardiovascular events in hypertension (HT). A high neutrophil to lymphocyte ratio (NLR) is correlated with high mortality and poor prognosis in cardiovascular disease. This study was performed to investigate the associations between NLR and different left ventricular (LV) geometric patterns in patients with newly diagnosed HT. Methods: The study population consisted of 222 patients with newly diagnosed HT (mean age: 53.2 ± 10.0 years). Echocardiographic examination was performed in all patients. Four different geometric patterns were determined in hypertensive patients according to the left ventricular mass index (LVMI) and relative wall thickness (RWT). Results: The baseline demographic characteristics were similar in all groups. The NLR and platelet to lymphocyte ratio (PLR) were higher in the eccentric hypertrophy and concentric hypertrophy groups compared to the normal geometry and concentric remodeling groups (p < 0.05, for all). NLR was positively and significantly correlated with LVMI (r = 0.508, p < 0.001). Linear regression analysis showed that LVMI was independently correlated with NLR (β = 5.440, p < 0.001), systolic blood pressure (β = 0.284, p < 0.001), ejection fraction (β = -0.201, p < 0.001), E/A (β = -2.270, p = 0.24), and high-density lipoprotein cholesterol (β = -0.245, p < 0.001). Conclusions: We demonstrated that patients with newly diagnosed HT with LVH had significantly higher NLR and PLR compared to those without LVH. In addition, NLR predicted LVH in hypertensive patients. The results of this study suggested that inflammation plays a role in the pathogenesis of LVH in hypertensive subjects. Original article *Corresponding author: Dr. Abdulmecit Afşin, Department of Cardiology, Adıyaman State Hospital, Adıyaman, Turkey, Tel: +90-537-721-66-73, Fax: +90-416725-65-02 1Department of Cardiology, Adıyaman State Hospital, Turkey 2Department of Cardiology, Training and Research Hospital, Turkey 3Department of Cardiology, Adıyaman University Faculty of Medicine, Turkey","PeriodicalId":91747,"journal":{"name":"Journal of hypertension and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49064484","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}
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