scholarly journals Low blood pressure phenotype underpins the tendency to reflex syncope

2020 ◽  
Author(s):  
Michele Brignole ◽  
Giulia Rivasi ◽  
Richard Sutton ◽  
Rose Anne Kenny ◽  
Carlos A Morillo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
Venous Return ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Reflex Syncope ◽  
Low Blood Pressure ◽  
Hemodynamic Profile ◽  
The Difference

AbstractBACKGROUNDWe hypothesized that cardiovascular physiology differs in reflex syncope patients compared with general population, predisposing such subjects to vasovagal reflex.METHODSIn this multicohort cross-sectional study, we compared resting systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and heart rate (HR), collected from 6 community-based cohort studies (64,968 observations) with those from 6 databases of reflex syncope patients (6516 observations), subdivided by age decades and sex.RESULTSOverall, in males with reflex syncope, SBP (−3.4 mmHg) and PP (−9.2 mmHg) were lower and DBP (+2.8 mmHg) and HR (+5.1 bpm) were higher than in the general population; the difference in SBP was higher at ages >60 years. In females, PP (−6.0 mmHg) was lower and DBP (+4.7 mmHg) and HR (+4.5 bpm) were higher than in the general population; differences in SBP were less pronounced, becoming evident only above 60 years. Compared with males, SBP in females exhibited slower increase until age 40, and then demonstrated steeper increase that continued throughout life.CONCLUSIONThe patients prone to reflex syncope demonstrate a different resting cardiovascular hemodynamic profile characterized by reduced venous return and stroke volume, evidenced by lower SBP and PP, and compensatory increase in HR and vascular resistance, the latter expressed by elevated DBP. The data presented here contribute to our understanding why some subjects with similar demographic characteristics develop reflex syncope and others not.

scholarly journals Heart rate variability and blood pressure among Japanese men and women: a community-based cross-sectional study

2014 ◽  
Vol 37 (8) ◽  
pp. 779-784 ◽  
Author(s):  
Hiromi Mori ◽  
Isao Saito ◽  
Eri Eguchi ◽  
Koutatsu Maruyama ◽  
Tadahiro Kato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Japanese Men ◽  
Men And Women

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.

scholarly journals Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031660 ◽  
Author(s):  
Yen-An Lin ◽  
Ying-Jen Chen ◽  
Yu-Chung Tsao ◽  
Wei-Chung Yeh ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Elderly Populations ◽  
Obesity Indices ◽  
Northern Taiwan

ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan Township of northern Taiwan.ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).Outcome measuresStatistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.ResultsOf the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.ConclusionsWC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.

scholarly journals Stigmatisation associated with COVID-19 in the general Colombian population

2020 ◽  
pp. 002076402097244
Author(s):  
Carlos Arturo Cassiani-Miranda ◽  
Adalberto Campo-Arias ◽  
Andrés Felipe Tirado-Otálvaro ◽  
Luz Adriana Botero-Tobón ◽  
Luz Dary Upegui-Arango ◽  
...  
Keyword(s):  
General Population ◽  
Research Team ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Additional Problem ◽  
The Difference ◽  
High Level

Background: As the COVID-19 pandemic progresses, the fear of infection increases and, with it, the stigma-discrimination, which makes it an additional problem of the epidemic. However, studies about stigma associated with coronavirus are scarce worldwide. Aims: To determine the association between stigmatisation and fear of COVID-19 in the general population of Colombia. Method: A cross-sectional study was carried out. A total of 1,687 adults between 18 and 76 years old ( M = 36.3; SD = 12.5), 41.1% health workers, filled out an online questionnaire on Stigma-Discrimination and the COVID-5 Fear Scale, adapted by the research team. Results: The proportion of high fear of COVID-19 was 34.1%; When comparing the affirmative answers to the questionnaire on stigma-discrimination towards COVID-19, it was found that the difference was significantly higher in the general population compared to health workers in most of the questions evaluated, which indicates a high level of stigmatisation in that group. An association between high fear of COVID-19 and stigma was evidenced in 63.6% of the questions in the questionnaire. Conclusion: Stigma-discrimination towards COVID-19 is frequent in the Colombian population and is associated with high levels of fear towards said disease, mainly people who are not health workers.

scholarly journals How is silent ‘non-alcoholic fatty liver disease’ epidemic perceived in India? A community based cross sectional study

2019 ◽  
Vol 6 (12) ◽  
pp. 5256
Author(s):  
Anurag Lavekar ◽  
Pradeep Tarikere Satyanarayana ◽  
Anagha Lavekar
Keyword(s):  
Liver Disease ◽  
General Population ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background: One of the diseases assuming fast importance is non-alcoholic fatty liver disease (NAFLD) which is a clinical syndrome characterized by predominant macrovesicular steatosis of the liver which is an umbrella term for a range of liver conditions affecting people who drink little or no alcohol. Only mild to moderate elevation of serum transaminases which could be only laboratory abnormality found in NAFLD. So with this background, the study was started with the objectives of assessing the perceptions of general population regarding NAFLD and factors influencing perceptions of general population regarding NAFLD.Methods: It was a community based cross sectional study carried out for a period of 12 months from January 2018 to December 2018 among in Nanded, Maharashtra. Around 422 households were involved after simple random sampling. To assess perceptions a pretested semi-structured questionnaire was used which had 27 questions. All data collected was entered in Microsoft excel and analysed using SPSS v22.Results: Out of 422 participants, 147 (34.8%) were in the age group of 31-40 years, 333 (78.9%) were male participants, 179 (42.5%) were graduates, 284 (67.3%) belonged to joint family, 140 (33.2%) belonged to Modified BG Prasad classification 2018. 181 (42.9%) had satisfactory perception regarding NAFLD. Females, participants aged more than 40 years, nuclear family participants had better scores.Conclusions: The present study showed majority of the participants had little awareness of NAFLD regardless of their age, gender, or educational status. Awareness of NAFLD must be promoted for prevention, early detection, and treatment especially counseling by primary care physicians preponderant influence in preventive strategy for NAFLD breaking the chain of disease progression.

P2649Do these data apply to me? Examining the applicability of trials assessing strategies for optimal management of blood pressure to older patients in UK primary care

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Sheppard ◽  
J Burt ◽  
M Lown ◽  
E Temple ◽  
R Lowe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
General Population ◽  
Older Patients ◽  
Random Effect ◽  
Cross Sectional Study ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Increased Risk ◽  
Cardiovascular Medications

Abstract Background There is debate as to what extent older patients (≥80 years) should be treated for high blood pressure. Existing trials show that blood pressure lowering in this population is effective at preventing stroke and heart failure but also results in an increased risk of adverse events. However, it has been suggested that these studies enrolled healthier patients, who are less representative of the general population and more likely to benefit from treatment. Purpose This study aimed to compare the characteristics of patients eligible for three blood pressure management trials and assess the likelihood of eligibility for each trial based on common characteristics of older patients. Methods Cross-sectional study of data extracted from the medical records of 15,376 patients aged ≥80 years, registered to 24 general practices in the south of England. Anonymised patient data relating to the eligibility criteria for two previous medication intensification trials (HYVET, SPRINT) and one medication reduction trial (OPTiMISE) were extracted. Patients eligible for each trial were defined according to criteria specified in each trial protocol. Descriptive statistics were used to define the characteristics of each trial population. A logistic regression model was constructed to estimate predictors of eligibility for each trial, with practice included as a random effect. Results Approximately 268 (1.7%), 5,290 (34.4%) and 3,940 (25.6%) patients were eligible for HYVET, SPRINT and OPTiMISE trials respectively. There was little overlap in eligibility for each trial (1.0% were eligible for HYVET and SPRINT; 0% were eligible for HYVET and OPTiMISE; 10.2% were eligible for SPRINT and OPTiMISE). Patients eligible for OPTiMISE were comparable to the general population in terms of frailty (eFI 0.12 [OPTiMISE] vs 0.11 [general population]), but had more morbidities (4 vs 3) and cardiovascular medications prescribed (4 vs 2). Patients in HYVET and SPRINT were less frail, multi-morbid and prescribed less cardiovascular medications. Overall, increasing frailty and a history of cardiovascular disease reduced the likelihood of being eligible for any trial. Conclusions Patients eligible for OPTiMISE appear to best represent the population aged ≥80 years attending UK primary care. Increasing frailty and/or multi-morbidity reduce the likelihood of eligibility for all three blood pressure trials. Caution should be exercised when applying the results from randomised controlled trials to management of blood pressure in frail and multi-morbid patients. Acknowledgement/Funding This study was funded by the National Institute for Health Research (NIHR) SPCR and Oxford CLAHRC

scholarly journals Association of Serum Uric Acid with Lung Function in the National Health and Nutrition Examination Survey (NHANES), 2007-2012: A Cross-Sectional Study.

2021 ◽  
Author(s):  
Wen Luo ◽  
Wanyu Wang ◽  
Xiangyang Yao ◽  
Yonghong Shi ◽  
Fang Lu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Lung Function ◽  
General Population ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Nutrition Examination Survey ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health And Nutrition

Abstract Background Evidence regarding the relationship between serum uric acid and lung function was controversial. Therefore, this study is designed to investigate whether serum uric acid was independently related to lung function in the National Health and Nutrition Examination Survey (NHANES) (2007-2012) after adjusting for other covariates. Methods The present study was a cross-sectional study. The total participants from NHANES (2007-2012) were 30442. After exclusion of subjects, 9474 subjects remained for the final analysis. The target independent variable and the dependent variable were serum uric acid measured at baseline and lung function respectively. Covariates involved in this study included age, sex, race, income-poverty ratio, body mass index, systolic blood pressure, diastolic blood pressure, blood urea nitrogen, cholesterol, creatinine, total protein, FeNO, calcium, alcohol drinking, smoke, phosphorus and total bilirubin. Results The average age of 9626 selected participants was 37.12 ± 16.03 years old, and about 49.19% of them were male. Result of fully adjusted linear regression showed serum uric acid was negatively associated with FEV1, FEV and PEF after adjusting confounders (Odds ratio (OR)= for FEV1 [-21.28 (-32.26, -10.30)], for FVC [-26.79 (-40.56, -13.01)] and for PEF [-72.19 (-101.93, -42.46)]). FEV1 and PEF were found a non-linear relationship with serum uric acid and the inflection points was 6.5mg/dl and 7.3 mg/dl respectively. The effect sizes and the confidence intervals in FEV1 and PEF of the left and right sides of inflection point were -11.50 (-25.55, 2.54) and -48.07 (-74.49, -21.66), -38.17 (-71.91, -4.43) and -311.11 (-427.28, -194.94) respectively. Conclusions We find serum uric acid was negatively associated with FEV1, FVC and PEF in a general population. Besides, there is a threshold effect on the independent association between serum uric acid and FEV1 and PEF. Those results are only found in the general population. Further epidemiologic studies will still be required to confirm this reverse association between serum uric acid and lung function.

scholarly journals An Investigation on the Patients Undergoing Kidney Stone Open Surgery: A Single-Center Report From Sistan and Baluchistan Province, Iran

2021 ◽  
Vol 6 (2) ◽  
pp. 64-68
Author(s):  
Amin Afshari Moghadam ◽  
Salehe Badini
Keyword(s):  
Blood Pressure ◽  
Kidney Stone ◽  
Cross Sectional Study ◽  
Urinary Stones ◽  
Cross Sectional ◽  
Postoperative Fever ◽  
Kidney Surgery ◽  
Duration Of Surgery ◽  
The Difference ◽  
Staghorn Stones

Introduction: Urinary stones are among major urological diseases. Open kidney surgery has always been of historical importance in the management of most urinary stones, especially in complicated cases. The aim of this study was to investigate the cases of open kidney stone surgery in Amir Al-Momenin hospital of Zabol in 2016-2017. Method: In the present descriptive cross-sectional study, the patients who underwent open kidney stone surgery in Amir Al-Momenin hospital were evaluated. The investigated variables included gender, age, changes in blood pressure, postoperative complications, and duration of surgery. The information was collected from hospital records and entered into SPSS software for analysis.Results: In this study, 25 patients were studied, of whom 14 (56%) were females. The mean age of the patients was 37.84 ±17.15 years. The youngest and oldest patients were 1 and 66 years old, respectively. Twelve patients (48%) had staghorn stones, and the rest (13 patients) had other types of stones. Blood pressure remained unchanged in 80% of the patients while 12% developed hypertension. Postoperative fever and infection were observed in only 4% of the patients. The prevalence of staghorn stones in men and women were 45.5% and 50%, respectively. The difference was not statistically significant (P = 0.821).Conclusion: The present study showed that the most common stones leading to open kidney surgery were of the staghorn type. Males were more likely to undergo open kidney surgery than females.

scholarly journals PRIMARY PPH;

2008 ◽  
Vol 15 (03) ◽  
pp. 335-340
Author(s):  
SAMIA SHUJA ◽  
AFIA ANSAR ◽  
NAGINA FATIMA LIAQUAT
Keyword(s):  
Blood Pressure ◽  
Study Design ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Medical Centre ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Difference ◽  
Uterine Fundus

. Objective: To determine the effectiveness and safety of uterine packing in selected cases of primarypostpartum haemorrhage. Study Design: Cross-sectional study. Place and Duration: The study was conducted atJinnah Postgraduate Medical Centre, Karachi, From September 2003 to April 2008. Patients and Methods: Womendeveloping primary PPH due to uterine atony, placenta previa and coagulation failure were selected for uterine packing.Firm packing was done with enormous length of sterile ribbon gauze, using ‘layering technique’ under prophylacticantibiotic cover. Vagina was also packed to give additional pressure. Pack was removed after 12 - 36 hours or earlyin case of failure to control haemorrhage. Pulse, blood pressure, soakage of pads, height of uterine fundus andtemperature were monitored to assess effectiveness and safety. Results: 39 women were included in the study. Causeof PPH was uterine atony in 30 (76.9%), coagulation failure in 5 (12.8%) and placenta previa in 4 (10.3%) cases.Packing was successful in arresting haemorrhage in 32 (82.1%) and failed in 7 (17.9%) cases; 95% Confidence Interval67-91. There was no case of concealed haemorrhage, four patients developed emdometritis and none had delayedhaemorrhage. 13 laparotomies were prevented. The difference between the causes of haemorrhage in successful andfailed cases did not show a definite trend. Conclusion: If employed early, uterine packing is a quick, effective and safemethod for controlling primary PPH in carefully selected cases.

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