Lower systolic blood pressure levels in early pregnancy are associated with a decreased risk of early-onset superimposed preeclampsia in women with chronic hypertension: a multicenter retrospective study

Abstract Flavan-3-ols are a group of bioactive compounds that have been shown to improve vascular function in intervention studies. They are therefore of great interest for the development of dietary recommendation for the prevention of cardio-vascular diseases. However, there are currently no reliable data from observational studies, as the high variability in the flavan-3-ol content of food makes it difficult to estimate actual intake without nutritional biomarkers. In this study, we investigated cross-sectional associations between biomarker-estimated flavan-3-ol intake and blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk in 25,618 participants of the European Prospective Investigation into Cancer (EPIC) Norfolk cohort. High flavan-3-ol intake, achievable as part of an habitual diet, was associated with a significantly lower systolic blood pressure (− 1.9 (− 2.7; − 1.1) mmHg in men and − 2.5 (− 3.3; − 1.8) mmHg in women; lowest vs highest decile of biomarker), comparable to adherence to a Mediterranean Diet or moderate salt reduction. Subgroup analyses showed that hypertensive participants had stronger inverse association between flavan-3-ol biomarker and systolic blood pressure when compared to normotensive participants. Flavanol intake could therefore have a role in the maintenance of cardiovascular health on a population scale.

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Outcome of Primary Intracerebral Hemorrhage: A Study in Tertiary Care Center

Eastern Green Neurosurgery ◽

10.3126/egn.v2i2.29246 ◽

2020 ◽

Vol 2 (2) ◽

pp. 35-40

Author(s):

Jagat Narayan Rajbanshi ◽

Pankaj Raj Nepal

Keyword(s):

Blood Pressure ◽

Intracerebral Hemorrhage ◽

Systolic Blood Pressure ◽

Care Center ◽

Tertiary Care ◽

Brain Parenchyma ◽

Chronic Hypertension ◽

Midline Shift ◽

Male Predominance ◽

The Mean

Background: Intracerebral hemorrhage (ICH) is an irreversible phenomenon inside the brain parenchyma resulting in mild to severe neurological deficit. Based on etiology it is broadly divided into primary and secondary. Primary ICH is usually due to the rupture of Charcot-Bouchard aneurysm and chronic hypertension. Charcot – Bouchard aneurysms are supposed to get formed due to lipohyalinosis. With the aim to evaluate the outcome of primary ICH admitted to our institute this study is performed. Materials and methods: This is a prospective analytical study, where all the consecutive patients of the primary ICH were collected. Quantitative variables like age, the volume of hematoma, midline shift, GCS, and systolic blood pressure (SBP) were presented as mean and standard deviation (S.D). Whereas, qualitative variables like gender, site, and side of hematoma, type of treatment, best motor response were presented in frequency and percentage. The outcome of the patient was measured using the Glasgow outcome scale (GOS) and the association between qualitative/quantitative variables and GOS was done using the chi-square test or Fischer exact test whenever applicable in SPSS20. Results: There were a total of 31 patients with a mean age of 59.81(S. D 15.8) year and male predominance (74%). The mean volume of hematoma was 40 ml. Similarly, midline shift ranged from zero to 14 mm. The majority of primary ICH were located in basal ganglia (35%) and on the right side (52%). The mean GCS at presentation was 12.1 (S.D 2.166). Mean Systolic blood pressure was 163.77 mmHg (S.D 34.6 mmHg) with maximum SBP up to 240mmHg. There was a 14% mortality in this study group with favorable outcome (GOS 4 and 5) in 82%. GOS was significantly associated with the volume of hematoma and midline shift. Conclusion: The outcome of primary ICH is strongly associated with the volume of hematoma and midline shift. They were generally associated with hypertension with a mean systolic blood pressure of >160 mm Hg.

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Variable versus fixed-rate infusion of phenylephrine during cesarean delivery: a randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-019-0879-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Ahmed Hasanin ◽

Sara Habib ◽

Yaser Abdelwahab ◽

Mohamed Elsayad ◽

Maha Mostafa ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Cesarean Delivery ◽

Controlled Trial ◽

Controlled Study ◽

Lower Systolic Blood Pressure ◽

Randomized Controlled ◽

Phenylephrine Infusion ◽

Infusion Regimen

Abstract Background Phenylephrine is the most commonly used vasopressor for prophylaxis against maternal hypotension during cesarean delivery; however, the best regimen for its administration is not well established. Although variable infusion protocols had been suggested for phenylephrine infusion, evidence-based evaluation of variable infusion regimens are lacking. The aim of this work is to compare variable infusion, fixed on-and-off infusion, and intermittent boluses of phenylephrine for prophylaxis against maternal hypotension during cesarean delivery. Methods A randomized controlled study was conducted, including full-term pregnant women scheduled for elective cesarean delivery. Participants were divided into three groups which received phenylephrine by either intermittent boluses (1.5 mcg/Kg phenylephrine), fixed on-and-off infusion (with a dose of 0.75 mcg/Kg/min), or variable infusion (with a starting dose of 0.75 mcg/Kg/min). The three groups were compared with regard to frequency of: maternal hypotension (primary outcome), second episode hypotension, reactive hypertension, and bradycardia. Other outcomes included heart rate, systolic blood pressure, physician interventions, and neonatal outcomes. Results Two-hundred and seventeen mothers were available for final analysis. The 2 infusion groups showed less incidence of maternal hypotension {26/70 (37%), 22/71 (31%), and (51/76 (67%)} and higher incidence of reactive hypertension compared to the intermittent boluses group without significant differences between the two former groups. The number of physician interventions was highest in the variable infusion group compared to the other two groups. The intermittent boluses group showed lower systolic blood pressure and higher heart rate compared to the two infusion groups; whilst the two later groups were comparable. Conclusion Both phenylephrine infusion regimens equally prevented maternal hypotension during cesarean delivery compared to intermittent boluses regimen. Due to higher number of physician interventions in the variable infusion regimen, the current recommendations which favor this regimen over fixed infusion regimen might need re-evaluation.

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Gender difference in cardiovagal baroreflex gain in humans

Journal of Applied Physiology ◽

10.1152/jappl.2001.91.5.2088 ◽

2001 ◽

Vol 91 (5) ◽

pp. 2088-2092 ◽

Cited By ~ 61

Author(s):

Stacy D. Beske ◽

Guy E. Alvarez ◽

Tasha P. Ballard ◽

Kevin P. Davy

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Gender Differences ◽

Systolic Blood Pressure ◽

Body Fat ◽

Aerobic Fitness ◽

Operating Point ◽

Body Fat Percentage ◽

Fat Percentage ◽

Lower Systolic Blood Pressure

We tested the hypothesis that women would demonstrate lower cardiovagal baroreflex gain compared with men. If so, we further hypothesized that the lower cardiovagal baroreflex gain in women would be associated with their lower aerobic fitness and higher body fat percentage compared with men. To accomplish this, we measured cardiovagal baroreflex gain (modified Oxford technique) in sedentary, nonobese (body mass index < 25 kg/m2) men (age = 26.0 ± 2.1 yr, n = 11) and women (age = 26.9 ± 1.6 yr, n = 14). Resting R-R interval and diastolic blood pressure were similar in the two groups, but systolic blood pressure was lower ( P < 0.05) in the women. Cardiovagal baroreflex gain was significantly lower in the women compared with the men (13.3 ± 1.5 vs. 20.0 ± 2.8 ms/mmHg, P< 0.05). The lower cardiovagal baroreflex gain in the women was not related ( P > 0.05) to their lower aerobic fitness and was only marginally related to their higher body fat percentage ( r = −0.34, P < 0.05). There were no gender differences in the threshold and saturation, operating range, or operating point (all P > 0.05), although the operating point fell significantly to left (i.e., at a lower systolic blood pressure) compared with men. Therefore, the findings of this study suggest that the gain of the cardiovagal baroreflex is reduced whereas other parameters were similar in women compared with men. The mechanisms responsible for the reduced cardiovagal baroreflex gain remain unclear.

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Success factors in high-effect, low-cost eHealth programs for patients with hypertension: a systematic review and meta-analysis

European Journal of Preventive Cardiology ◽

10.1177/2047487320957170 ◽

2020 ◽

pp. 204748732095717

Author(s):

Sebastiaan Blok ◽

Eva L van der Linden ◽

G Aernout Somsen ◽

Igor I Tulevski ◽

Michiel M Winter ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Usual Care ◽

High Intensity ◽

Success Factors ◽

Meta Analysis ◽

High Volume ◽

Partial Replacement ◽

Lower Systolic Blood Pressure ◽

High Effect

Background eHealth programs can lower blood pressure but also drive healthcare costs. This study aims to review the evidence on the effectiveness and costs of eHealth for hypertension and assess commonalities in programs with high effect and low additional cost. Results Overall, the incremental decrease in systolic blood pressure using eHealth, compared to usual care, was 3.87 (95% confidence interval (CI) 2.98–4.77) mmHg at 6 months and 5.68 (95% CI 4.77–6.59) mmHg at 12 months’ follow-up. High intensity interventions were more effective, resulting in a 2.6 (95% CI 0.5–4.7) (at 6 months) and 3.3 (95% CI 1.4–5.1) (at 12 months) lower systolic blood pressure, but were also more costly, resulting in €170 (95% CI 56–284) higher costs at 6 months and €342 (95% CI 128–556) at 12 months. Programs that included a high volume of participants showed €203 (95% CI 99–307) less costs than those with a low volume at 6 months, and €525 (95% CI 299–751) at 12 months without showing a difference in systolic blood pressure. Studies that implemented eHealth as a partial replacement, rather than addition to usual care, were also less costly (€119 (95% CI –38–201 at 6 months) and €346 (95% CI 261–430 at 12 months)) without being less effective. Evidence on eHealth programs for hypertension is ambiguous, heterogeneity on effectiveness and costs is high ( I2 = 56–98%). Conclusion Effective eHealth with limited additional costs should focus on high intensity interventions, involve a large number of participants and use eHealth as a partial replacement for usual care.

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Social integration after moving to a new city predicts lower systolic blood pressure

Psychophysiology ◽

10.1111/psyp.13924 ◽

2021 ◽

Author(s):

Charlotte M. Roddick ◽

Chelsea D. Christie ◽

Kenneth M. Madden ◽

Frances S. Chen

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Social Integration ◽

Lower Systolic Blood Pressure ◽

New City

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Clinical Effect of Naturally Random Allocation to Lower Systolic Blood Pressure Beginning Before the Development of Hypertension

Hypertension ◽

10.1161/hypertensionaha.113.02734 ◽

2014 ◽

Vol 63 (6) ◽

pp. 1182-1188 ◽

Cited By ~ 48

Author(s):

Brian A. Ference ◽

Stevo Julius ◽

Nitin Mahajan ◽

Phillip D. Levy ◽

Kim Allan Williams ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Clinical Effect ◽

Random Allocation ◽

Lower Systolic Blood Pressure

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Safety and Feasibility of Achieving Lower Systolic Blood Pressure Goals in Persons With Type 2 Diabetes: The SANDS Trial

Journal of Clinical Hypertension ◽

10.1111/j.1751-7176.2009.00121.x ◽

2009 ◽

Vol 11 (10) ◽

pp. 540-548 ◽

Cited By ~ 15

Author(s):

Matthew R. Weir ◽

Fawn Yeh ◽

Angela Silverman ◽

Richard B. Devereux ◽

James M. Galloway ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Systolic Blood Pressure ◽

Lower Systolic Blood Pressure ◽

Blood Pressure Goals

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Paraoxonase 2 Cys311Ser polymorphism and its association with the systolic blood pressure values in asymptomatic dyslipidemic individuals: a pilot study

LaboratoriumsMedizin ◽

10.1515/labmed-2015-0009 ◽

2015 ◽

Vol 39 (4) ◽

Author(s):

Dalibor Novotny ◽

David Karasek ◽

Helena Vaverkova ◽

Margita Bartkova ◽

Veronika Kubickova

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Adhesion Molecule ◽

Apolipoprotein A1 ◽

Lower Systolic Blood Pressure ◽

Reactive Protein ◽

Hemostatic Markers ◽

Cell Adhesion Molecule 1 ◽

Relationship Of ◽

The Relationship

AbstractThe study aimed to evaluate the relationship of paraoxonase 2 (Two hundred and sixty-four individuals were included in the study. The laboratory parameters were assessed by routine kit methods, while methods based on polymerase chain reaction were used for311 SS homozygous individuals had significantly lower systolic blood pressure values (SBP, p<0.01), C-reactive protein, and apolipoprotein A1 levels (p<0.05), as compared with C allele carriers. The analysis revealed no differences in the levels of endothelial/hemostatic markers, except for the increased adhesion molecule [soluble vascular cell adhesion molecule 1 (sVCAM-1)] concentrations in 311S/E2 carriers (p<0.05).The presence of the

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