scholarly journals Lower Systolic Blood Pressure and Cardiovascular Event Risk Stratified by Renal Resistive Index in Hospitalized Cardiovascular Patients: J-VAS Study

2018 ◽  
Vol 32 (4) ◽  
pp. 365-374 ◽  
Author(s):  
Praew Kotruchin ◽  
Satoshi Hoshide ◽  
Hiromi Ueno ◽  
Takahiro Komori ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cardiovascular Event ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
Lower Systolic Blood Pressure ◽  
Event Risk ◽  
Cardiovascular Patients

scholarly journals Longitudinal prospective observational type study about determinants of renal resistive index variations in chronic renal failure patients treated with conventional medical and dietetic therapy

2017 ◽  
Vol 89 (4) ◽  
pp. 305
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini ◽  
Vanni Giovannelli ◽  
Giuseppe Romano
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Doppler Ultrasonography ◽  
Urinary Albumin Excretion ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
The Mean ◽  
Renal Doppler Ultrasonography ◽  
Renal Doppler

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.

scholarly journals Comparison of renal arterial resistive index in type 2 diabetic nephropathy stage 0-4

2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Sharareh Sanei Sistani ◽  
Ali Alidadi ◽  
Alireza Ansari Moghadam ◽  
Fatemeh Mohamadnezhad ◽  
Bahareh Heshmat Ghahderijani
Keyword(s):  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistive Index ◽  
Chronic Kidney Failure ◽  
World Health ◽  
Renal Resistive Index ◽  
Cross Sectional ◽  
Cardiovascular Morbidity And Mortality

Chronic kidney disease (CKD) is one of world health problems and its prevalence and incidence is increasing. Chronic Kidney Failure involves a range of pathophysiologic processes that are associated with impaired renal function, leading to cardiovascular morbidity and mortality. Renal artery resistive index (RI) is indicator of atherosclerotic change in small vessels. The current study was aimed to assess RI in diabetic nephropathy patients at stage 0-4 and to compare RRI with HbA1c, systolic blood pressure, diastolic blood pressure, albuminuria and glomerular filtration rate (GFR). In this cross sectional study,100 diabetic nephropathy patients who attend to nephrology clinic of Ali-ibn Abi Talib Hospital were entered to the study. Ultrasound Doppler renal resistive index was measured and other information was recorded from their last lab data that was recorded in their medical records. Variable included: systolic blood pressure, diastolic blood pressure, albuminuria, GFR, HbA1c. All data was analyzed by Pearson's Correlation Coefficient. The findings indicated a significant correlation of RI with systolic BP (p=0.04 R=0.75), microalbuminuria (P=0.001 R=0.67), and GFR (P=0.001 R=0.76), while diastolic BP (P=0/45 R=0/32), HbA1c (P=0/56 R=0/43) were not found to be associated with RI. The findings indicated that increased systolic blood pressure, albumin excretion (microalbuminuria) and severity of disease were capable of increasing RI values in diabetic nephropathy patients. In addition, decreased GFR.

scholarly journals Low systolic blood pressure values, renal resistive index measurement and glomerular filtration rate in a non-dialysis dependent chronic kidney disease population

2019 ◽  
Vol 90 (4) ◽  
pp. 288-292
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Systolic Blood Pressure ◽  
Filtration Rate ◽  
Left Kidney ◽  
Resistive Index ◽  
Renal Resistive Index

Objective: A longitudinal prospective case control study was organized to explore the relationships between glomerular filtration rate (GFR), renal resistive index (RRI) and blood pressure values in a non-dialysis dependent adult population affected by chronic kidney disease and exposed to low systolic blood pressure (SBP) values.Material and methods: The study sample (54 patients: 31 males and 23 females with an average age of 61.7 ± 19.2 years) was randomly selected from a population of adult non-dialysis dependent patients that scored a SBP < 100 mmHg at the medical examination. The patients were equally divided in two groups defined by the presence and absence of chronic kidney disease, (i.e. a GFR less or greater than 60 ml/min/1.73 m2, respectively). Patients were submitted to a full therapeutic and dietetic intervention to correct the hypotension until reaching a steady SBP > 100 mmHg. Results: In the group with chronic renal disease, the comparison between the data recorded with SBP < 100 mmHg (t0) and those detected with SBP ≥ 100 mmHg (t1) showed a statistically significant decrease of serum creatinine as well as an increase of GFR (mean serum creatinine t0 – serum creatinine t1: 0.194 ± 0.35, p < 0.01; mean GFR t0 – GFR t1: -4.615 ± 8.8, p < 0.013). There was also a statistically significant reduction of the RRI (mean right kidney RRI t0 – mean right kidney RRI t1: + 0.082 ± 0.03, p < 0; mean left kidney RRI t0 – mean left kidney RRI t1: 0.076 ± 0.03, p < 0). Conclusion: We concluded that, in CKD, when aorta is stiffed, a decrease of SBP can limit the renal perfusion that, in this condition, is mostly dependent by stroke volume, causing an increase of RRI and a decrease of GFR that we suppose as reversible with the restoration of SBP.

scholarly journals Ratio of diastolic to systolic blood pressure represents renal resistive index

2019 ◽  
Vol 34 (7) ◽  
pp. 512-519 ◽  
Author(s):  
Tetsuya Akaishi ◽  
Michiaki Abe ◽  
Takashi Miki ◽  
Mika Miki ◽  
Yasuharu Funamizu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Vascular Resistance ◽  
Pulse Pressure ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Resistive Index ◽  
Renal Resistive Index

Abstract Increased intrarenal vascular resistance is suggested to accompany chronic kidney diseases (CKD), which is known to be closely associated with hypertension. However, there are few studies that have examined the relationship between blood pressure and intrarenal vascular resistance. Renal color Doppler ultrasonography is one method that can non-invasively evaluate intrarenal vascular resistance. In this study, we comprehensively studied the correlations between ultrasonic parameters and blood pressure indices to elucidate their relationships. In total, 162 patients with suspected CKD were enrolled for this study. Demographics, blood pressure, blood test, urine test, and renal color Doppler ultrasonography data were obtained. The ratio of diastolic to systolic blood pressure (D/S ratio) and pulse pressure were calculated. Our results indicated strong negative correlations between the renal resistive index (RI) values in all four of the studied kidney regions and the D/S ratio. The RI values also showed significant correlations with diastolic pressure and pulse pressure, but they were weaker. Partial correlation coefficients between pulse pressure, mean arterial pressure, D/S ratio, and RI showed that D/S ratio significantly correlated with RI, but pulse pressure or mean arterial pressure did not. Systolic blood pressure did not correlate with any of the studied ultrasonic values. The negative correlation between RI values and the D/S ratio was still observed in subjects without renal dysfunction or any medications. In conclusion, D/S ratio, rather than pulse pressure or mean arterial pressure, would be the most appropriate index to estimate/calculate/judge intrarenal vascular resistance.

scholarly journals Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Javier I. Ottaviani ◽  
Abigail Britten ◽  
Debora Lucarelli ◽  
Robert Luben ◽  
Angela A. Mulligan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Vascular Function ◽  
Cardiovascular Health ◽  
Vascular Diseases ◽  
Inverse Association ◽  
Cvd Risk ◽  
Lower Systolic Blood Pressure ◽  
Cross Sectional ◽  
Salt Reduction

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.

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

2019 ◽  
Vol 19 (1) ◽  
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.

scholarly journals Gender difference in cardiovagal baroreflex gain in humans

2001 ◽  
Vol 91 (5) ◽  
pp. 2088-2092 ◽  
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.

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

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.

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

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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