Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in ...Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.展开更多
Objective:Hypertension is a serious public health concern that is influenced by a variety of body composition parameters.This study examines the associations between body composition metrics and blood pressure(BP)in a...Objective:Hypertension is a serious public health concern that is influenced by a variety of body composition parameters.This study examines the associations between body composition metrics and blood pressure(BP)in a rural population,specifically how variations in body fat distribution and other metrics affect systolic blood pressure(SBP)and diastolic blood pressure(DBP).Methods:A cross-sectional study of 226 participants examined the relationships between body composition metrics—such as total body fat,visceral fat,and body mass index(BMI)—and BP.Correlation and regression analyses were used to assess these relationships.Results:The study found substantial positive correlations between visceral fat and total body fat with both SBP and DBP.Visceral fat was strongly connected with both SBP(r=0.145,P=0.030)and DBP(r=0.331,P<0.01),while total body fat was significantly correlated with DBP(r=0.268,P<0.01)but not SBP.Body composition variables explained 12.8% of the variance in SBP(R^(2)=0.128,P=0.001)and 15.0% in DBP(R^(2)=0.150,P<0.001).Conclusions:The study found substantial connections between body composition,particularly visceral and subcutaneous fat and systolic and DBP.Higher levels of visceral fat were linked to elevate BP.Body composition accounted for a significant amount of BP fluctuation.展开更多
While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the assoc...While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.展开更多
Accurate blood pressure(BP)monitoring is essential for preventing and managing cardiovascular disease.Advancements in materials science,medicine,flexible electronic,and artificial intelligence(AI)have enabled cuffless...Accurate blood pressure(BP)monitoring is essential for preventing and managing cardiovascular disease.Advancements in materials science,medicine,flexible electronic,and artificial intelligence(AI)have enabled cuffless,unobtrusive BP monitoring systems,offering an alternative to traditional sphygmomanometers.However,extending these advances to real-world cardiovascular care particularly in resource-limited settings remains challenging due to constraints in computational resources,power efficiency,and deployment scalability.This review presents a comprehensive synthesis of AI-enhanced wearable BP monitoring,emphasizing its potential for personalized,scalable,and accessible healthcare.We systematically analyze the end-to-end system architecture,from mechano-electric sensing principles and AI-based estimation models to edge-aware deployment strategies tailored for low-resource environments.We further discuss clinical validation metrics and implementation barriers and prospective strategies.To bridge lab-to-field translation,we propose an innovative"sensor-model-deployment-assessment"co-design framework.This roadmap highlights how AI-enhanced BP technologies can support proactive hypertension control and promote cardiovascular health equity on a global scale.展开更多
Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabo...Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a...Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.展开更多
Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions,...Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.展开更多
Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study wa...Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.展开更多
Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benef...Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.展开更多
Dear Editor,The paper“Effects of a culture-specific behavior modification program on glycated hemoglobin and blood pressure among adults with diabetes and hypertension:A randomized controlled trial”[1]shows that an ...Dear Editor,The paper“Effects of a culture-specific behavior modification program on glycated hemoglobin and blood pressure among adults with diabetes and hypertension:A randomized controlled trial”[1]shows that an Information-Motivation-Behavioral Skills(IMB)-based,culturally tailored program combining dietary education,context-fit physical activity,and medication-adherence support via interactive classes and a mobile web app achieved significant 12-week reductions in HbA1c and blood pressure versus usual care.In practice,the cultural tailoring comprised Thai/Isan-specific diet guidance(the 6S-6O-1S limits on sugar[e.g.,“≤6 tsp sugar,≤6 tsp oil,≤1 tsp salt/day],oil/fat,and salt,alongside carbohydrate counting,glycemic index use,and label reading)and Soeng Isan dance to Mor Lam music for activity,while skills training covered correct medication use,individualized goal setting,and device-tracked self-monitoring reinforced by the app,nurses,and peers.展开更多
Background:Hypertension is a prevalent non-communicable disease that remains a significant public health challenge.Self-efficacy,an individual’s belief in their capacity to manage their health,is crucial for controll...Background:Hypertension is a prevalent non-communicable disease that remains a significant public health challenge.Self-efficacy,an individual’s belief in their capacity to manage their health,is crucial for controlling blood pressure.Methods:This study utilized a descriptive analytic design with a cross-sectional approach.A sample of 134 individuals with hypertension from the Sukorejo Public Health Center’s working area in Jember Regency was selected via stratified random sampling.Data were gathered using the General Self-Efficacy Scale questionnaire and a calibrated digital sphygmomanometer.The Spearman-rho test was used for data analysis due to non-normally distributed data.Results:The findings revealed that a majority of respondents had low self-efficacy(39.6%).The mean systolic blood pressure was 157.88 mmHg and diastolic was 92.82 mmHg,classifying most participants as having stage 1 hypertension.The Spearman-rho test identified a significant,albeit very weak,negative relationship between self-efficacy and systolic blood pressure(r=-0.205,P=0.017).However,no significant relationship was found with diastolic blood pressure(P=0.237).Conclusion:Self-efficacy is an important factor in hypertension management,particularly in influencing systolic blood pressure.Therefore,nursing interventions focused on improving self-efficacy,such as targeted health education,peer support groups,and skill-building workshops,are recommended to empower individuals to manage their condition effectively.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
Background The co-existence of Type 2 diabetes mellitus(T2DM)and hypertension presents a significant clinical challenge due to their synergistic detrimental effects on cardiovascular outcomes.Conventional combination ...Background The co-existence of Type 2 diabetes mellitus(T2DM)and hypertension presents a significant clinical challenge due to their synergistic detrimental effects on cardiovascular outcomes.Conventional combination therapies often fall short in comprehensively addressing the intertwined pathophysiologies,particularly vascular endothelial dysfunction.This study aimed to evaluate the efficacy of a novel regimen combining sitagliptin-metformin with nifedipine in managing blood pressure,blood glucose,and vascular function in this high-risk population.Methods 150 patients with T2DM and hypertension were randomly assigned to either the control group(n=75)treated with metformin and nifedipine,or the experimental group(n=75)treated with sitagliptin-metformin compound preparation combined with nifedipine.Changes in blood pressure,blood glucose levels,flow-mediated dilation(FMD)and nitroglycerin-mediated dilation(NMD)of the brachial artery,and serum levels of biomarkers[nitric oxide(NO),endothelin-1(ET-1)]were compared before and after treatment.The incidence of adverse reactions during treatment was also monitored.Results After treatment,both groups showed significant reductions in blood pressure,blood glucose parameters,and ET-1 levels compared to baseline.The experimental group demonstrated significantly lower values in these assessments at the same time points than control group(P<0.05).Conversely,FMD,NMD,and NO levels increased significantly in both groups after treatment,with experimental group showing significantly higher values than control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of sitagliptinmetformin compound preparation and nifedipine significantly enhanced blood pressure control and blood glucose control and exerted a positive regulatory effect on vascular endothelial function in patients with T2DM and hypertension,demonstrating high clinical value for widespread application.展开更多
[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024...[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.展开更多
Metabolic dysfunction-associated steatotic liver disease(MASLD)requires accurate liver fibrosis assessment for management.While liver biopsy remains the gold standard,its invasiveness drives demand for non-invasive bi...Metabolic dysfunction-associated steatotic liver disease(MASLD)requires accurate liver fibrosis assessment for management.While liver biopsy remains the gold standard,its invasiveness drives demand for non-invasive biomarkers.This review evaluates blood biomarkers for MASLD fibrosis staging.Established scores(fibrosis-4,non-alcoholic fatty liver disease fibrosis score)offer accessible screening but exhibit variable performance influenced by age,obesity,and comorbidities.Patented panels(e.g.,enhanced liver fibrosis test,FibroMeter)improve accuracy by integrating extracellular matrix or metabolic markers,though context-specific thresholds are essential.Emerging biomarkers like propeptide of type 3 collagen,Mac-2 binding protein glycosylation isomer,epigenetic markers(proliferator-activated receptor-γmethylation),and angiopoietin-like proteins a family of eight glycoproteins show promise but require large-scale validation.Genetic risk scores and multi-omics approaches face generalizability challenges.Integration strategies,such as combining serum biomarkers with liver stiffness measurement via Agile scores,enhance diagnostic precision and reduce indeterminate classifications.Current tools aid risk stratification,but no single biomarker replicates biopsy-level precision.Future efforts must prioritize MASLD-specific diagnostic frameworks,standardized protocols,and multi-modal integration to enhance clinical utility and address MASLD’s growing burden.展开更多
Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital f...Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.展开更多
G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population b...G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population but lacks functional evidence for salt-sensitivity.In this prospective study,we identified rs1801058 genotypes by sequencing in hypertensives patients and analyzed the variant's effects on blood pressure response to acute salt loading in 150 newly diagnosed hypertension patients.Our data indicated that there were no statistically significant difference in blood pressure changes between the overall rs1801058 genotype groups.Carriers of the C allele showed a significant rise in heart rate change according to acute saline loading.Among patients age≤40year,T allele carriers showed higher changes in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)than C allele carriers when diuretic shrinkage.GRK4 single rs1801058 polymorphism cannot directly explain salt sensitivity in the Chinese hypertension patients.展开更多
Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patie...Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
文摘Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.
基金supported by Universitas Advent Indonesia(No.067/EKS-SU/V/24 and 389/KEPK-FIK.UNAI/EC/V/24)。
文摘Objective:Hypertension is a serious public health concern that is influenced by a variety of body composition parameters.This study examines the associations between body composition metrics and blood pressure(BP)in a rural population,specifically how variations in body fat distribution and other metrics affect systolic blood pressure(SBP)and diastolic blood pressure(DBP).Methods:A cross-sectional study of 226 participants examined the relationships between body composition metrics—such as total body fat,visceral fat,and body mass index(BMI)—and BP.Correlation and regression analyses were used to assess these relationships.Results:The study found substantial positive correlations between visceral fat and total body fat with both SBP and DBP.Visceral fat was strongly connected with both SBP(r=0.145,P=0.030)and DBP(r=0.331,P<0.01),while total body fat was significantly correlated with DBP(r=0.268,P<0.01)but not SBP.Body composition variables explained 12.8% of the variance in SBP(R^(2)=0.128,P=0.001)and 15.0% in DBP(R^(2)=0.150,P<0.001).Conclusions:The study found substantial connections between body composition,particularly visceral and subcutaneous fat and systolic and DBP.Higher levels of visceral fat were linked to elevate BP.Body composition accounted for a significant amount of BP fluctuation.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82192900,82192901,82192904,81390540,and 91846303 to L.L.)the National Key Research and Development Program of China(Grant No.2016YFC0900500 to Y.G.)the Kadoorie Charitable Foundation in Hong Kong,and the Wellcome Trust in the UK(Grant/Award Nos.088158/Z/09/Z,104085/Z/14/Z,and 202922/Z/16/Z to Z.C.).
文摘While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.
文摘Accurate blood pressure(BP)monitoring is essential for preventing and managing cardiovascular disease.Advancements in materials science,medicine,flexible electronic,and artificial intelligence(AI)have enabled cuffless,unobtrusive BP monitoring systems,offering an alternative to traditional sphygmomanometers.However,extending these advances to real-world cardiovascular care particularly in resource-limited settings remains challenging due to constraints in computational resources,power efficiency,and deployment scalability.This review presents a comprehensive synthesis of AI-enhanced wearable BP monitoring,emphasizing its potential for personalized,scalable,and accessible healthcare.We systematically analyze the end-to-end system architecture,from mechano-electric sensing principles and AI-based estimation models to edge-aware deployment strategies tailored for low-resource environments.We further discuss clinical validation metrics and implementation barriers and prospective strategies.To bridge lab-to-field translation,we propose an innovative"sensor-model-deployment-assessment"co-design framework.This roadmap highlights how AI-enhanced BP technologies can support proactive hypertension control and promote cardiovascular health equity on a global scale.
基金supported by the National Science and Technology Major Program for Noncommunicable Chronic Diseases(2023ZD0503500)the National Natural Science Foundation of China(82030102,12126602,91857118)+1 种基金the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSP-GG-2)。
文摘Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
基金supported by the 90th Anniversary of Chulalong-korn University Scholarship(Ratchadaphiseksomphot Endowment Fund)。
文摘Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.
文摘Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.
文摘Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.
基金supported by the National Natural Science Foundation of China(82170375,U23A20395)1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University(ZYGD23021,23HXF-H009)Sichuan Science and Technology Program 2023NSFSC1645。
文摘Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.
文摘Dear Editor,The paper“Effects of a culture-specific behavior modification program on glycated hemoglobin and blood pressure among adults with diabetes and hypertension:A randomized controlled trial”[1]shows that an Information-Motivation-Behavioral Skills(IMB)-based,culturally tailored program combining dietary education,context-fit physical activity,and medication-adherence support via interactive classes and a mobile web app achieved significant 12-week reductions in HbA1c and blood pressure versus usual care.In practice,the cultural tailoring comprised Thai/Isan-specific diet guidance(the 6S-6O-1S limits on sugar[e.g.,“≤6 tsp sugar,≤6 tsp oil,≤1 tsp salt/day],oil/fat,and salt,alongside carbohydrate counting,glycemic index use,and label reading)and Soeng Isan dance to Mor Lam music for activity,while skills training covered correct medication use,individualized goal setting,and device-tracked self-monitoring reinforced by the app,nurses,and peers.
文摘Background:Hypertension is a prevalent non-communicable disease that remains a significant public health challenge.Self-efficacy,an individual’s belief in their capacity to manage their health,is crucial for controlling blood pressure.Methods:This study utilized a descriptive analytic design with a cross-sectional approach.A sample of 134 individuals with hypertension from the Sukorejo Public Health Center’s working area in Jember Regency was selected via stratified random sampling.Data were gathered using the General Self-Efficacy Scale questionnaire and a calibrated digital sphygmomanometer.The Spearman-rho test was used for data analysis due to non-normally distributed data.Results:The findings revealed that a majority of respondents had low self-efficacy(39.6%).The mean systolic blood pressure was 157.88 mmHg and diastolic was 92.82 mmHg,classifying most participants as having stage 1 hypertension.The Spearman-rho test identified a significant,albeit very weak,negative relationship between self-efficacy and systolic blood pressure(r=-0.205,P=0.017).However,no significant relationship was found with diastolic blood pressure(P=0.237).Conclusion:Self-efficacy is an important factor in hypertension management,particularly in influencing systolic blood pressure.Therefore,nursing interventions focused on improving self-efficacy,such as targeted health education,peer support groups,and skill-building workshops,are recommended to empower individuals to manage their condition effectively.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
文摘Background The co-existence of Type 2 diabetes mellitus(T2DM)and hypertension presents a significant clinical challenge due to their synergistic detrimental effects on cardiovascular outcomes.Conventional combination therapies often fall short in comprehensively addressing the intertwined pathophysiologies,particularly vascular endothelial dysfunction.This study aimed to evaluate the efficacy of a novel regimen combining sitagliptin-metformin with nifedipine in managing blood pressure,blood glucose,and vascular function in this high-risk population.Methods 150 patients with T2DM and hypertension were randomly assigned to either the control group(n=75)treated with metformin and nifedipine,or the experimental group(n=75)treated with sitagliptin-metformin compound preparation combined with nifedipine.Changes in blood pressure,blood glucose levels,flow-mediated dilation(FMD)and nitroglycerin-mediated dilation(NMD)of the brachial artery,and serum levels of biomarkers[nitric oxide(NO),endothelin-1(ET-1)]were compared before and after treatment.The incidence of adverse reactions during treatment was also monitored.Results After treatment,both groups showed significant reductions in blood pressure,blood glucose parameters,and ET-1 levels compared to baseline.The experimental group demonstrated significantly lower values in these assessments at the same time points than control group(P<0.05).Conversely,FMD,NMD,and NO levels increased significantly in both groups after treatment,with experimental group showing significantly higher values than control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of sitagliptinmetformin compound preparation and nifedipine significantly enhanced blood pressure control and blood glucose control and exerted a positive regulatory effect on vascular endothelial function in patients with T2DM and hypertension,demonstrating high clinical value for widespread application.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2021GG0117).
文摘[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.
基金Supported by the National Natural Science Foundation of China,No.82402719Sichuan Science and Technology Program,No.2025ZNSFSC1553.
文摘Metabolic dysfunction-associated steatotic liver disease(MASLD)requires accurate liver fibrosis assessment for management.While liver biopsy remains the gold standard,its invasiveness drives demand for non-invasive biomarkers.This review evaluates blood biomarkers for MASLD fibrosis staging.Established scores(fibrosis-4,non-alcoholic fatty liver disease fibrosis score)offer accessible screening but exhibit variable performance influenced by age,obesity,and comorbidities.Patented panels(e.g.,enhanced liver fibrosis test,FibroMeter)improve accuracy by integrating extracellular matrix or metabolic markers,though context-specific thresholds are essential.Emerging biomarkers like propeptide of type 3 collagen,Mac-2 binding protein glycosylation isomer,epigenetic markers(proliferator-activated receptor-γmethylation),and angiopoietin-like proteins a family of eight glycoproteins show promise but require large-scale validation.Genetic risk scores and multi-omics approaches face generalizability challenges.Integration strategies,such as combining serum biomarkers with liver stiffness measurement via Agile scores,enhance diagnostic precision and reduce indeterminate classifications.Current tools aid risk stratification,but no single biomarker replicates biopsy-level precision.Future efforts must prioritize MASLD-specific diagnostic frameworks,standardized protocols,and multi-modal integration to enhance clinical utility and address MASLD’s growing burden.
文摘Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.
文摘G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population but lacks functional evidence for salt-sensitivity.In this prospective study,we identified rs1801058 genotypes by sequencing in hypertensives patients and analyzed the variant's effects on blood pressure response to acute salt loading in 150 newly diagnosed hypertension patients.Our data indicated that there were no statistically significant difference in blood pressure changes between the overall rs1801058 genotype groups.Carriers of the C allele showed a significant rise in heart rate change according to acute saline loading.Among patients age≤40year,T allele carriers showed higher changes in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)than C allele carriers when diuretic shrinkage.GRK4 single rs1801058 polymorphism cannot directly explain salt sensitivity in the Chinese hypertension patients.
文摘Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).
