Perceived social support and ambulatory blood pressure during daily life: a meta-analysis

Abstract Background Hypertension augments overall cardiovascular risk in patients with type 2 diabetes mellitus (T2DM), constituting a major additional burden for diabetic subjects; however, control rates of hypertension remain suboptimal. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), second-line treatment option for diabetics, have revolutionized the field of T2DM therapeutic management due to their pleiotropic effects, while they seem to hold multiple cardiovascular benefits. A few randomized controlled trials (RCTs) evaluated the effect of GLP-1RAs on ambulatory blood pressure (ABP). Ambulatory blood pressure monitoring (ABPM) provides a better method to predict long-term cardiovascular outcomes than office blood pressure. Purpose We sought to determine the effect of GLP-1RAs on ABPM, pooling data from relevant randomized controlled trials (RCTs). Methods We searched 2 major electronic databases, namely PubMed and Cochrane/CENTRAL, along with grey literature sources, for RCTs assessing the effect of various GLP-1RAs on ABP in patients with T2DM. Results After screening of the potentially eligible records, 7 RCTs were finally included in our meta-analysis (4 parallel-group and 3 cross-over). GLP-1RA treatment compared to placebo or active control resulted in a nonsignificant decrease in 24-h systolic blood pressure (MD=−1.57 mm Hg, 95% CI: −4.12 to 0.98, I2=63%) (Figure 1) and in 24-h diastolic blood pressure (MD=1.28 mmHg, 95% CI: −0.31 to 2.87, I2=49%) (Figure 2). No subgroup differences between the various GLP-1RAs were identified. More specifically, it was demonstrated that liraglutide once daily produced a non-significant decrease in 24-h systolic blood pressure (MD=−1.43 mm Hg, 95% CI: −5.24 to 2.38, I2=72%) and a non-significant increase in 24-h diastolic blood pressure (MD=1.47 mm Hg, 95% CI: −1.12 to 4.05, I2=61%), while data concerning the effect of once weekly dulaglutide and twice daily exenatide on ABPM were pooled from one RCT respectively (Figures 1, 2). Conclusions Antidiabetic treatment with GLP-1RAs does not influence either systolic or diastolic ABP in patients with T2DM. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

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GAMBARAN KONFLIK INTRAPERSONAL & PERCEIVED SOCIAL SUPPORT PADA IBU YANG KEMBALI BEKERJA SETELAH MEMILIKI ANAK PERTAMA

MANASA ◽

10.25170/manasa.v9i2.1964 ◽

2020 ◽

Vol 9 (2) ◽

pp. 30-44

Author(s):

Carrisa Christianty Putri ◽

Fransisca Rosa Mira Lentari

Keyword(s):

Social Support ◽

Return To Work ◽

Working Mothers ◽

Qualitative Method ◽

Perceived Social Support ◽

Daily Life ◽

Intrapersonal Conflict ◽

First Child ◽

Double Approach ◽

Approach Avoidance

Working mothers who just had their first child face major changes in aspects of their life. Workingmothers have two roles that must be fulfilled in their daily life, being a mother and a worker. Thedemands of these roles often create pressures that cause conflict within the mother herself.Conflicts that occur within herself are called intrapersonal conflicts. This study aims to overviewintrapersonal conflicts and perceived social support in mothers who return to work after havingtheir first child. The method used in this research is a qualitative method with semi-structuredinterview methods involving two participants who work professionally and have their first childaged 0-18 months. The results of this study indicate that there is an intrapersonal conflict in theroles of mother and worker. The type of conflict that arose in the two participants was the type ofmultiple/double approach-avoidance conflict in which the two alternative choices, working andcaring for children, both had negative and positive values for the participants. Both participantsstated that the existence of social support from people around them, can help participants dealwith intrapersonal conflicts when they have to work leaving their children.

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