scholarly journals The International Database of Central Arterial Properties for Risk Stratification: Research Objectives and Baseline Characteristics of Participants

2021 ◽  
Author(s):  
Lucas S Aparicio ◽  
Qi-Fang Huang ◽  
Jesus D Melgarejo ◽  
Dong-Mei Wei ◽  
Lutgar de Thijs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Meta Analysis ◽  
Aortic Pulse Wave Velocity ◽  
International Database ◽  
Cross Sectional ◽  
Research Perspectives ◽  
Central Hemodynamic ◽  
Hemodynamic Measurements

Abstract Objective To address to what extent central hemodynamic measurements, improve risk stratification, and determine outcome-based diagnostic thresholds, we constructed the International Database of Central Arterial Properties for Risk Stratification (IDCARS), allowing a participant-level meta-analysis. The purpose of this article was to describe the characteristics of IDCARS participants and to highlight research perspectives. Methods Longitudinal or cross-sectional cohort studies with central blood pressure measured with the SphygmoCor devices and software were included. Results The database included 10930 subjects (54.8% women; median age 46.0 years) from thirteen studies in Europe, Africa, Asia and South America. The prevalence of office hypertension was 4446 (40.1%), of which 2713 (61.0%) were treated, and of diabetes mellitus was 629 (5.8%). The peripheral and central systolic/diastolic blood pressure averaged 129.5/78.7 mm Hg and 118.2/79.7 mm Hg, respectively. Mean aortic pulse wave velocity was 7.3 meter per seconds. Among 6871 participants enrolled in 9 longitudinal studies, the median follow-up was 4.2 years (5th–95th percentile interval, 1.3–12.2 years). During 38957 person-years of follow-up, 339 participants experienced a composite cardiovascular event and 212 died, 67 of cardiovascular disease. Conclusions IDCARS will provide a unique opportunity to investigate hypotheses on central hemodynamic measurements that could not reliably be studied in individual studies. The results of these analyses might inform guidelines and be of help to clinicians involved in the management of patients with suspected or established hypertension.

Cardiovascular Responses to Muscle Stretching: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Ewan Thomas ◽  
Marianna Bellafiore ◽  
Ambra Gentile ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Vascular Function ◽  
Meta Analysis ◽  
Random Effect ◽  
Cardiovascular Responses ◽  
Qualitative Description ◽  
Cross Sectional ◽  
Quantitative Synthesis

AbstractThe aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a “fair-to-good” quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.

scholarly journals Arm Based on LEg blood pressures (ABLE-BP): can systolic leg blood pressure measurements predict systolic brachial blood pressure? Protocol for an individual participant data meta-analysis from the INTERPRESS-IPD Collaboration

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040481
Author(s):  
Sinead T J McDonagh ◽  
James P Sheppard ◽  
Fiona C Warren ◽  
Kate Boddy ◽  
Leon Farmer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Public Involvement ◽  
Meta Analysis ◽  
Patient And Public Involvement ◽  
Prognostic Models ◽  
Individual Participant Data ◽  
Dissemination Strategy ◽  
Cross Sectional ◽  
Individual Participant ◽  
Meta Analyses

IntroductionBlood pressure (BP) is normally measured on the upper arm, and guidelines for the diagnosis and treatment of high BP are based on such measurements. Leg BP measurement can be an alternative when brachial BP measurement is impractical, due to injury or disability. Limited data exist to guide interpretation of leg BP values for hypertension management; study-level systematic review findings suggest that systolic BP (SBP) is 17 mm Hg higher in the leg than the arm. However, uncertainty remains about the applicability of this figure in clinical practice due to substantial heterogeneity.AimsTo examine the relationship between arm and leg SBP, develop and validate a multivariable model predicting arm SBP from leg SBP and investigate the prognostic association between leg SBP and cardiovascular disease and mortality.Methods and analysisIndividual participant data (IPD) meta-analyses using arm and leg SBP measurements for 33 710 individuals from 14 studies within the Inter-arm blood pressure difference IPD (INTERPRESS-IPD) Collaboration. We will explore cross-sectional relationships between arm and leg SBP using hierarchical linear regression with participants nested by study, in multivariable models. Prognostic models will be derived for all-cause and cardiovascular mortality and cardiovascular events.Ethics and disseminationData originate from studies with prior ethical approval and consent, and data sharing agreements are in place—no further approvals are required to undertake the secondary analyses proposed in this protocol. Findings will be published in peer-reviewed journal articles and presented at conferences. A comprehensive dissemination strategy is in place, integrated with patient and public involvement.PROSPERO registration numberCRD42015031227.

Abstract P262: Spot Urine Sodium to Potassium Ratio Predicts Increasing Blood Pressure Levels in a General Population: The Nagahama Study

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Yasuharu Tabara ◽  
Yoshimitsu Takahashi ◽  
Takeo Nakayama ◽  
Fumihiko Matsuda
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Linear Regression Analysis ◽  
Prognostic Significance ◽  
Reverse Causality ◽  
Cross Sectional ◽  
Salt Loading ◽  
Available N ◽  
Spot Urine

Excessive salt intake is a risk factor for hypertension. The most reliable method for estimating daily salt intake is measurement of 24-h urinary sodium excretion, while it is inconvenient. Sodium-to-potassium ratio (Na/K) of a urine sample is another index of salt loading. We previously reported that a simple measure of spot urine Na/K might be a representative of salt loading in a cross-sectional setting. Here, we conducted a longitudinal study aiming to clarify a prognostic significance of spot urine Na/K for increasing blood pressure (BP) levels. Study subjects consists of 9,769 general individuals. Among them, individuals whose baseline Na/K was available (n=9,328), who were normotensive at baseline (n=6,392), and who participated in the follow-up measurement (n=5,209) were included in this analysis (51.8±12.9 years old, male: 29.2%). Mean follow-up duration was 5.0±0.5 years. Mean Na/K at baseline was 3.1±1.7, and showed step-wise increase with BP levels (optimal: 3.0±1.6, normal: 3.3±1.8, high normal: 3.4±1.8, P<0.001). Other major factors that were significantly associated with Na/K was fasting time (r=-0.220, P<0.001), and CKD (CKD (n=694): 2.7±1.6, control: 3.2±1.7, P<0.001). Mean SBP was significantly increased during follow-up period (baseline: 116±12, follow-up: 119±15 mmHg), and 805 individuals (15.5%) were newly diagnosed as hypertension (HT). These individuals were significantly older (HT: 60.3±9.9, NT: 50.3±12.8 years), were frequently male (36.4%, 27.9%), and had higher SBP (127±9, 115±11 mmHg) at baseline (P<0.001). In contrast, baseline spot urine Na/K was slightly lower in individuals who developed HT (3.0±1.6, 3.1±1.8, P=0.013), while that measured at follow-up investigation was oppositely higher in hypertensives (3.1±1.8, 2.8±1.5, P<0.001). Multiple linear regression analysis adjusted for the covariates identified baseline Na/K (β=0.108, P<0.001) and changes in Na/K during follow-up period (β=0.222, P<0.001) as independent determinants for future SBP levels. Higher spot urine Na/K, as well as increases in the Na/K levels, was significant determinant for future BP levels. The apparently lower baseline Na/K levels in individuals who developed HT might be due to reverse causality.

scholarly journals Cervical cancer: Renal complications and survival after percutaneous nephrostomy

2016 ◽  
Vol 62 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Alzira Carvalho Paula de Souza ◽  
Alfredo Nunes Souza ◽  
Rubens Kirsztajn ◽  
Gianna Mastroianni Kirsztajn
Keyword(s):  
Blood Pressure ◽  
Cervical Cancer ◽  
Renal Function ◽  
Percutaneous Nephrostomy ◽  
Cross Sectional Study ◽  
Obstructive Nephropathy ◽  
Cross Sectional ◽  
Low Blood Pressure ◽  
Northern Brazil

SUMMARY Introduction: Obstructive nephropathy is a frequent complication in the course of advanced cervical cancer (CC), and ultrasonography-guided percutaneous nephrostomy (PCN) is a well established technique for fast ureteral desobstruction. Objective: To identify possible factors related to the survival and quality of life of patients with advanced CC presenting acute urinary obstructive complications that after desobstruction by PCN recovered urinary flux and renal function. Method: This is an analytical, descriptive, cross-sectional study that included 45 patients with CC who underwent PCN and were divided into 2 groups: “death” (DG) and “survival” (SG), in a public hospital that is reference for oncologic diseases in Northern Brazil. Results: The mean serum creatinine of the patients preceding PCN was >10 mg/dL, and after PCN <2 mg/dL. The cutoffs of 8.7 g/dL for Hb (p=0.0241) and 27% for Ht (p=0.0065) indicated the values that better discriminate the outcomes of the groups. The presence of low blood pressure was statistically correlated (p=0.0037) to the outcome “death”. Changes in glomerular filtration rate (already reduced in all cases) were not associated to the levels of Hb/Ht or to the outcome “death” during the nephrological follow-up. Conclusion: PCN was responsible for the recovery of renal function in 61.7% of the patients, leading to interruption of renal replacement therapy (RRT) in all of those patients. Hb levels >8.7g/dL and Ht >27% were associated to longer survival, and the presence of low blood pressure during follow-up was associated with progression to death.

Predictors of blood pressure in a cohort of school-aged children

2007 ◽  
Vol 14 (5) ◽  
pp. 624-629 ◽  
Author(s):  
Masoud Mirzaei ◽  
Richard Taylor ◽  
Stephen Morrell ◽  
Stephen R. Leeder
Keyword(s):  
Blood Pressure ◽  
Socioeconomic Status ◽  
Primary Schools ◽  
Longitudinal Change ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
School Aged Children ◽  
European Society Of Cardiology ◽  
Current Weight

Objectives To examine anthropometric measures and birthweight as predictors of blood pressure (BP) in a cohort of children. Design Cross-sectional and longitudinal study comprising baseline anthropometric and BP measurements conducted in 1994 ( n = 1230), with follow-up in 1997 ( n = 628). Setting Seventy-five inner-Sydney primary schools. Participants School children aged 8-9 years at baseline and 11-12 years at follow-up. Main outcome measures Systolic and diastolic BP (SBP and DBP). Study factors Current weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHR), weight gain since birth and birth weight. Potential confounders: age, sex and socioeconomic status (on the basis of the area of residence). Results Current weight was significantly associated with both SBP and DBP in boys and girls at baseline and follow-up. BMI and WC were similar predictors of SBP and DBP in each survey, but longitudinal BMI change has a stronger association with SBP ( r = 0.43, P <0.001) and DBP ( r = 0.26, P < 0.001) than changes in WC (r = 0.18, P < 0.001 for SBP and r = 0.16, P < 0.001 for DBP) and WHR in boys with the similar results for girls. The unadjusted associations between SBP and DBP and birthweight were nonsignificant. After adjustments for age, height and socioeconomic status, however, the association becomes negative and significant in boys (β = −1.47, P = 0.04 for SBP and β = −1.33, P = 0.03 for DBP). Conclusion Longitudinal change in BMI is a better predictor of BP than change in WC or the WHR, although cross-sectional measurements of BMI and WC are very similar predictors of BP. In preventing subsequent adverse effects on BP, attending to body weight during childhood is important. Eur J Cardiovasc Prev Rehabil 14:624-629 © 2007 The European Society of Cardiology

Dietary acid load and cardiometabolic risk factors: a systematic review and meta-analysis of observational studies

2019 ◽  
Vol 22 (15) ◽  
pp. 2823-2834 ◽  
Author(s):  
Elnaz Daneshzad ◽  
Fahimeh Haghighatdoost ◽  
Leila Azadbakht
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Observational Studies ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Cardiometabolic Risk Factors ◽  
Cross Sectional ◽  
Dietary Acid ◽  
Acid Load

AbstractObjective:Dietary acid load (DAL) might contribute to change the levels of cardiometabolic risk factors; however, the results are conflicting. The present review was conducted to determine the relationship between DAL and cardiometabolic risk factors.Design:Systematic review and meta-analysis.Setting:A systematic search was conducted in electronic databases including ISI Web of Science, PubMed/MEDLINE, Scopus and Google Scholar for observational studies which assessed cardiometabolic risk factors across DAL. Outcomes were lipid profile, glycaemic factors and anthropometric indices. Effect sizes were derived using a fixed- or random-effect model (DerSimonian–Laird). Also, subgroup analysis was performed to find the probable source of heterogeneity. Egger’s test was performed for finding any publication bias.Results:Thirty-one studies were included in the current review with overall sample size of 92 478. There was a significant relationship between systolic blood pressure (SBP; weighted mean difference (WMD) = 1·74 (95 % CI 0·25, 3·24) mmHg;P= 0·022;I2= 95·3 %), diastolic blood pressure (DBP; WMD = 0·75 (95 % CI 0·07, 1·42) mmHg;P= 0·030;I2= 80·8 %) and DAL in cross-sectional studies. Serum lipids, glycaemic parameters including fasting blood sugar, glycated Hb, serum insulin, homeostatic model assessment of insulin resistance and waist circumference had no significant relationship with DAL. No publication bias was found. BMI was not associated with DAL in both cross-sectional and cohort studies.Conclusions:Higher DAL is associated with increased SBP and DBP. More studies are needed to find any relationship of DAL with lipid profile and glycaemic factors.

Sleep Restriction Effects on BP: Systematic Review & Meta-analysis of RCTs

2019 ◽  
Vol 42 (7) ◽  
pp. 567-576
Author(s):  
Shan Hu ◽  
Songbo Jing ◽  
Yixuan Gao
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Sleep Restriction ◽  
Forest Plot ◽  
Cross Sectional ◽  
Inverse Variance ◽  
Partial Sleep Deprivation

This systematic review and meta-analysis aimed to examine the effect of sleep restriction on blood pressure (BP) among healthy adults. Randomized controlled trials (RCTs) using partial sleep deprivation were included. The pooled effect size was calculated by the inverse variance method, and forest plot was used. Six studies were included (n = 10–43). Only one study obtained continuous BP readings. Overall, sleep restriction did not result in significant changes in systolic blood pressure (SBP) or diastolic blood pressure (DBP) and heart rate (HR). The respective weighted mean difference (MD) was 1.0 mmHg (95%CI, -2.3–4.2; p = 0.57), -0.4 mmHg (95%CI, -3.2–2.4; p = 0.80), and 2.0 bpm (95%CI, -2.2–6.2; p = 0.34). There is preliminary evidence suggesting that sleep restriction might affect sympathetic/parasympathetic modulation of cardiac autonomy and the inflammatory system. In this review, we did not find significant effects of sleep restriction on BP or HR measured by cross-sectional methods. More studies are warranted to confirm these findings by using continuous monitoring.

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