P4562Bilateral sphenopalatine ganglion block reduces blood pressure in never treated hypertensive patients. A randomized controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Triantafyllidi ◽  
C Arvaniti ◽  
A Schoinas ◽  
D Benas ◽  
D Voutsinos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Controlled Study ◽  
Control Group ◽  
Sham Operation ◽  
Study Group ◽  
Sphenopalatine Ganglion ◽  
Night Time ◽  
Hypertensive Patients ◽  
Sham Operation Group

Abstract Background Sphenopalatine ganglion (SPG) area is connected through sympathetic fibers with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 53 newly diagnosed and never treated hypertensive patients (study group, mean age 49+12 years, 38 men) and a sham operation with water for injection in 11 patients (control group, mean age 51+12 years, 8 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters derived from ABPM (blood pressure, heart rate, blood pressure load and variability). We defined as responders to SBG block those patients with a 24h average SBP decrease >5 mmHg. Results In the study group, a month after SPG block: a. 24h average SBP and DBP were reduced by 1.3+7mmHg and 1.8+5 mmHg, respectively, and b. 24h average DBP (p=0.03), daytime DBP (p=0.01) and daytime DBP load (p=0.01) were significantly decreased. Interestingly, in the responders group (14/42, 33%) a month after SPG block: a. 24h average SBP and DBP were reduced by 9+4mmHg and 6.5+3 mmHg, respectively, b. SBP and DBP were decreased during overall 24h and daytime (p<0.001) and night-time periods (p=0.002 and p=0.02, respectively) and c. SBP load was decreased during daytime and night-time while DBP load was decreased during daytime (p<0.001). As it was expected, no differences regarding BP were found in the sham operation group. BP decrease after SPG block Conclusions We have proved that the minimally invasive option of the SPG block leads to blood pressure decrease, probably through SNS modulation. Moreover, due to its short-term anesthetic effect, SPG block might act as a method of selection of those hypertensives with an activated SNS before any other invasive procedure.

Bilateral sphenopalatine ganglion block reduces blood pressure and blood pressure variability in never treated patients with essential hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Triantafyllidi ◽  
C Arvaniti ◽  
D Benas ◽  
A Schoinas ◽  
D Voutsinos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Control Group ◽  
Sham Operation ◽  
Study Group ◽  
Sphenopalatine Ganglion ◽  
Night Time ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background Sphenopalatine ganglion (SPG) area is connected through sympathetic fibers with the central nervous system. It is already known that SPG infiltration by lidocaine reduced blood pressure in naïve hypertensive patients. Blood pressure variability (BPV) has been associated with an increased risk of cardiovascular events and mortality, independently of elevated BP levels. We aimed to study the effect of SPG block in BPV in never treated patients with stage I–II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 47 newly diagnosed and never treated hypertensive patients (study group, mean age 50±12 years, 31 men) and a sham operation with water for injection in 11 patients (control group, mean age 51±12 years, 8 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring (ABPM) prior and a month after the SPG block in order to estimate any differences in BP parameters derived from ABPM (BP, BPV). We defined as responders to SBG block those patients with a 24h average SBP decrease &gt;5 mmHg. Results We noticed the following significant differences in the study group: a. 24h average DBP and daytime DBP were reduced by 1.6±5 mmHg (p=0.04) and 1.9±5 mmHg (p=0.01) respectively and b. systolic BPV during daytime (11±2 mmHg vs. 10±2 mmHg, p&lt;0.05). Interestingly, in the responders group (14/47, 30%, 9 men, age = 47±8 mmHg) and a month after SPG block we noticed that: a. 24h average, daytime, night-time SBP and 24h average, daytime, night-time DBP were reduced by 9±4 mmHg (p&lt;0.001), 9±3 mmHg (p&lt;0.001), 7±7 mmHg (p=0.002) and 6.5±3 mmHg (p&lt;0.001), 6.5±3 mmHg (p&lt;0.001), 4±7 mmHg (p=0.02), respectively and b. systolic BPV during daytime (13±2 mmHg vs. 9±2 mmHg, p=0.01). No differences regarding BPV were found in the non-responders and the sham operation group. Conclusions SPG block is a promising, minimally invasive option of significant BP and BPV decrease in never treated hypertensive patients, especially during daytime activities when SNS is activated. It acts probably through SNS modulation. Since its effect is only anesthetic and non-permanent, SPG block might permit the selection of the hypertensive patients with an activated SNS before any other invasive antihypertensive procedure. SPG block reduces BP variability Funding Acknowledgement Type of funding source: None

Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

2021 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Control Group ◽  
Poor Sleep ◽  
Study Group ◽  
Confounding Factors ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

scholarly journals Efficacy of solifenacin in the prevention of short-term complications after laparoscopic radical prostatectomy

2017 ◽  
Vol 45 (6) ◽  
pp. 2119-2127
Author(s):  
Ranxing Yang ◽  
Lijie Liu ◽  
Gaofeng Li ◽  
Jianjun Yu
Keyword(s):  
Radical Prostatectomy ◽  
Short Form ◽  
Laparoscopic Radical Prostatectomy ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Urinary Flow ◽  
Short Term ◽  
Night Time

Objective To evaluate the efficacy of solifenacin in the prevention of short-term complications after laparoscopic radical prostatectomy (LRP). Methods This randomized placebo-controlled study enrolled patients with histologically proven prostate cancer who underwent LRP. The patients were randomized to receive either solifenacin (5 mg once daily; study group) or placebo (control group) for the 15-day period beginning on the first day after surgery. The mean duration of detrusor overactivity (DO), the frequency of DO, the duration of macroscopic haematuria, and the days before catheter removal were recorded. The International Continence Society Short Form Male questionnaire, bladder neck stenosis episodes, and maximum urinary flow rate were evaluated at 1 month after surgery. The side-effects after using solifenacin were also recorded. Results A total of 120 patients were randomly assigned to the study group ( n = 62) or the control group ( n = 58). There were significantly lower rates of DO episodes during the daytime and night-time, haematuria and transient incontinence in the study group compared with the control group. Conclusion Solifenacin was a well-tolerated and effective treatment for the prevention of complications after LRP, with the main advantage compared with placebo being the decreased frequency of DO episodes during the daytime and night-time.

scholarly journals The Effects of Renal Nerve Denervation on Blood Pressure and Target Organs in Different Hypertensive Rat Models

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Demin Liu ◽  
Jing Wang ◽  
Haijuan Hu ◽  
Guoqiang Gu ◽  
Rui Ding ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Secondary Hypertension ◽  
Control Group ◽  
Sham Operation ◽  
Renal Nerve ◽  
Rat Models ◽  
Sham Operation Group ◽  
Hypertensive Rat ◽  
Wistar Kyoto ◽  
Organ Changes

Background. Hypertension contributes to the progression of cardiac remodeling and renal damage. In turn, renal sympathetic hyperactivation showed elevated sympathetic nervous system activity and led to blood pressure increase in certain patients. The purpose of this study was to observe the effect of renal nerve denervation on blood pressure and target organ changes in two hypertensive rat models. Methods. Hypertensive rats were randomly divided into a renal denervation (RDN) group and sham operation group. Wistar–Kyoto (WKY) rats of the same age were set as the baseline control group. In the secondary hypertension model, SD rats were randomly divided into five groups. Blood pressure and bodyweight were measured every week until they were euthanized. Results. The two rat models underwent RDN at key timepoints. At these timepoints, the hearts and kidneys were collected for norepinephrine and angiotensin II measurements and histological analysis. Conclusion. RDN performed before development of hypertension showed a significant antihypertensive effect on the secondary hypertension model.

scholarly journals Biochemical and Chemical Lipid Profile and Blood Pressure Assessment in Arterial Hypertension with Chronic Kidney Disease

2020 ◽  
Vol 71 (7) ◽  
pp. 425-435
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Lipid Profile ◽  
Blood Pressure Monitoring ◽  
Hdl Cholesterol ◽  
Night Time ◽  
Hypertensive Patients ◽  
Lipid Disorders

Accelerated atherosclerosis and cardiovascular diseases are frequent complications in hypertensive patients with chronic kidney disease (CKD), being mainly driven by cardiovascular risk factors as lipid disorders and an unfavorable blood pressure profile. The objectives of the study were to evaluate the lipid profile and to assess the characteristics of blood pressure (BP) in patients with primary arterial hypertension associating chronic kidney disease (CKD) in a primary care population in Timis County, Romania. Lipid disorders were highly prevalent in hypertensive patients with CKD, consisting in hyper LDL-cholesterolemia in 50.3%, hypertriglyceridemia in 52%, low HDL-cholesterol levels in 35.8%. More than 2 lipid abnormalities were present in 68.8% of CKD hypertensive. CKD hypertensive patients, compared with those without CKD, presented a BP profile with higher systolic and diastolic office BP. On ambulatory blood pressure monitoring they also registred higher systolic and diastolic BP, the systolic BP (SBP), both for 24 h SBP, day-time and night-time SBP being statistically significant higher than in hypertensive patients without CKD. The circadian 24 h BP profile demonstrated in the CKD hypertensive population an unfavourable nocturnal profile in 67%, consisting of a high prevalence of the non-dipping profile and of nocturnal riser pattern.

scholarly journals Community Health Management and Nursing Strategies for Elderly Hypertension

2021 ◽  
Vol 5 (6) ◽  
pp. 135-138
Author(s):  
Qize Zhong ◽  
Wanling Chen
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Community Health ◽  
Health Management ◽  
Control Group ◽  
Study Group ◽  
Hypertensive Patients ◽  
Satisfaction Rate ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Objective: To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients. Methods: A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected. The control group took conventional care and guidance. The research group carried out community health management and nursing strategy guidance on the basis of the control group. Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’ satisfaction with nursing. Results: Through comparison, it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing. After nursing, the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg. The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg. There are obvious differences in the comparison of the two sets of data. By comparing the two groups of patients’ satisfactions with nursing care, it can be seen that among the 32 patients in the study group: 31 were very satisfied and basically satisfied, with a satisfaction rate of 96.87%. Among the 32 patients in the control group, 28 were very satisfied and basically satisfied, with a satisfaction rate of 87.5%. The data of the two groups of patients are clearly comparable. Conclusion: Through community health management and nursing strategies, the satisfaction and treatment effect of elderly hypertensive patients can be improved, thereby contributing to the recovery of patients.

scholarly journals The Expression of IL-12 Family Members in Patients with Hypertension and Its Association with the Occurrence of Carotid Atherosclerosis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jing Ye ◽  
Yuan Wang ◽  
Zhen Wang ◽  
Ling Liu ◽  
Zicong Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Atherosclerosis ◽  
Blood Pressure Monitoring ◽  
Family Members ◽  
Interleukin 12 ◽  
Control Group ◽  
Atherosclerotic Plaques ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
Control Subjects

Background. The interleukin-12 (IL-12) family consists of four members, namely, IL-12, IL-23, IL-27, and IL-35. The aim of this study was to examine the expression of circulating IL-12, IL-23, IL-27, and IL-35 in hypertensive patients. Methods. Blood samples were collected from hypertensive patients and nonhypertensive (control) subjects, and protein multifactorial monitor kits were used to measure the plasma IL-12, IL-23, IL-27, and IL-35 levels in each sample. In addition, all enrolled subjects underwent ambulatory blood pressure monitoring (ABPM) and vascular stiffness. Results. Hypertensive patients exhibited higher IL-12, IL-23, and IL-27 levels and lower IL-35 levels than control subjects; IL-12, IL-23, and IL-27 levels were positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP), while IL-35 levels were negatively correlated with SBP and DBP. IL-12, IL-23, and IL-27 levels gradually increased in patients with grade I, II, and III hypertension, while IL-35 levels gradually reduced. According to the ABPM results, hypertensive patients were divided into the dipper and nondipper hypertension groups; IL-12, IL-23, IL-27, and IL-35 levels showed no differences between the two groups, but IL-12, IL-23, and IL-27 levels in both groups increased compared with those in the control group, while IL-35 levels decreased. Additionally, the expression of these IL-12 family members was influenced by many clinical factors and was independently associated with the occurrence of carotid atherosclerotic plaques. Conclusions. The changes in IL-12, IL-23, IL-27, and IL-35 levels were not associated with the presence of the nondipper type but were closely associated with the development of carotid atherosclerotic plaque in hypertensive patients.

scholarly journals Effect of renal denervation on prenatal programming of hypertension and renal tubular transporter abundance

2008 ◽  
Vol 295 (1) ◽  
pp. F29-F34 ◽  
Author(s):  
Amit Dagan ◽  
H. Moo Kwon ◽  
Vangipuram Dwarakanath ◽  
Michel Baum
Keyword(s):  
Blood Pressure ◽  
Renal Denervation ◽  
Control Group ◽  
Renal Nerves ◽  
Sham Operation ◽  
Protein Abundance ◽  
Prenatal Programming ◽  
Sham Operation Group ◽  
Renal Tubular ◽  
Type 3

Prenatal glucocorticoids are often administered to pregnant women to accelerate pulmonary maturation. We have demonstrated that administration of dexamethasone during specific periods of pregnancy in the rat causes hypertension in the offspring when they are studied as adults. The purpose of the present study was to determine whether the hypertension due to prenatal dexamethasone was mediated by renal nerves. We administered dexamethasone to rats daily for 4 days between days 15 and 18 of gestation. Rats underwent bilateral renal denervation or sham operation at 6 wk of age, and blood pressure was measured at 8 wk of age. Prenatal dexamethasone in the sham operation group resulted in an increase in blood pressure compared with vehicle-treated sham controls (134 ± 3 vs. 145 ± 3 mmHg, P < 0.05). Renal denervation did not affect blood pressure significantly in the prenatal vehicle-treated control group but resulted in normalization in blood pressure in the prenatal dexamethasone group and (130 ± 3 and 128 ± 5 mmHg, respectively). Prenatal dexamethasone increased type 3 Na+/H+ exchanger (NHE3), Na+-K+-2Cl− cotransporter (NKCC2), and Na+-Cl− cotransporter (NCC), but not α-, β-, and γ-epithelial Na+ channel (ENaC) protein abundance compared with controls. The increase in NHE3, NKCC2, and NCC protein abundance by prenatal dexamethasone was not seen in 8-wk-old rats 2 wk after renal denervation. Renal denervation did not affect NHE3, NKCC2, and NCC protein abundance in prenatal vehicle-treated animals. This study is consistent with renal nerves playing a role in mediating the hypertension by prenatal programming by dexamethasone.

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diagnostic Methods ◽  
Control Group ◽  
Study Group ◽  
Media Thickness ◽  
Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

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