scholarly journals Pulse Wave Calibration and Implications for Blood Pressure Measurement

Hypertension ◽  
2021 ◽  
Author(s):  
Dawid Jedrzejewski ◽  
Ewan McFarlane ◽  
Peter S. Lacy ◽  
Bryan Williams
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Pulse Wave ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Weighted Mean ◽  
Brachial Blood Pressure ◽  
Peripheral Pulse

Central aortic systolic pressure (CASP) can be estimated via filtering of the peripheral pulse wave (PPW) following calibration to brachial blood pressure. Recent studies suggest PPW calibration to mean arterial pressure (MAP) and diastolic BP (DBP) provides more accurate CASP estimates (CASP MD ) versus conventional calibration to systolic BP (SBP) and DBP (CASP SD ). However, the peak of the MAP-DBP calibrated PPW, that is, SBP MD , is rarely reported or used for BP amplification calculations, despite CASP MD being derived from it. We aimed to calculate the unreported SBP MD from studies using MAP-DBP calibration for estimation of CASP MD and compared it with oscillometric brachial SBP (brSBP). Medline database was searched to March 18, 2020. Meta-analysis includes studies reporting noninvasive CASP SD , CASP MD , brSBP, and brachial DBP. SBP MD was calculated using linear function equations. Data from 21 studies used 8 different BP monitors (13 460 participants, mean age: 54±10 years, 57% female, brachial blood pressure: 130±14/79±9 mm Hg). Weighted mean difference between SBP MD and brSBP was 10 mm Hg (range, −2 to 17 mm Hg) and appeared device specific. Calibration of brachial versus radial PPWs to brachial blood pressure showed a greater disparity between SBP MD and brSBP (14 versus 2 mm Hg). BP amplification was similar comparing SBP-DBP versus MAP-DBP calibrations (brSBP-CASP SD versus SBP MD -CASP MD : 9 versus 11 mm Hg), with no instances of reverse BP amplification. PPWs calibrated to MAP-DBP to derive CASP MD generates SBP MD that differs markedly from brSBP with some oscillometric BP monitors. These findings have important implications for BP monitor accuracy, BP amplification, PPW calibration recommendations, and studies of associations between CASP versus SBP and outcomes.

scholarly journals Right Ventricular Function and Region-Specific Adaptation in Athletes Engaged in High-Dynamic Sports: A Meta-Analysis

2021 ◽  
Author(s):  
Tony G. Dawkins ◽  
Bryony A. Curry ◽  
Stephen P. Wright ◽  
Victoria L. Meah ◽  
Zaheer Yousef ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Systolic Pressure ◽  
Mean Difference ◽  
Functional Adaptation ◽  
Athlete’S Heart ◽  
Free Wall ◽  
Weighted Mean ◽  
Athlete's Heart

Background: Structural remodeling of the right ventricle (RV) is widely documented in athletes. However, functional adaptation, including RV pressure generation and systolic free-wall longitudinal mechanics, remains equivocal. This meta-analysis compared RV pressure and function in athletes and controls. Methods: A systematic review of online databases was conducted up to June 4, 2020. Meta-analyses were performed on RV systolic pressures, at rest and during exercise, tricuspid annular plane systolic displacement, myocardial velocity (S’), and global and regional longitudinal strain. Bias was assessed using Egger regression for asymmetry. Data were analyzed using random-effects models with weighted mean difference and 95% CI. Results: Fifty-three studies were eligible for inclusion. RV systolic pressure was obtained from 21 studies at rest ( n =1043:1651; controls:athletes) and 8 studies during exercise ( n =240:495) and was significantly greater in athletes at rest (weighted mean difference, 2.9 mmHg [CI, 1.3–4.5 mmHg]; P =0.0005) and during exercise (11.0 [6.5–15.6 mm Hg]; P <0.0001) versus controls. Resting tricuspid annular plane systolic displacement ( P <0.0001) and S’ ( P =0.001) were greater in athletes. In contrast, athletes had similar RV free-wall longitudinal strain (17 studies; n =450:605), compared with controls but showed greater longitudinal apical strain (16 studies; n =455:669; 0.9%, 0.1%–1.8%; P =0.03) and lower basal strain (−2.5% [−1.4 to −3.5%]; P <0.0001). Conclusions: Functional RV adaptation, characterized by increased tricuspid annular displacement and velocity and a greater base-to-apex strain gradient, is a normal feature of the athlete’s heart, together with a slightly elevated RV systolic pressure. These findings contribute to our understanding of RV in athletes and highlight the importance of considering RV function in combination with structure in the clinical interpretation of the athlete’s heart.

scholarly journals Effect of Ketamine/Propofol Admixture on Peri-Induction Hemodynamics: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Nathan J. Smischney ◽  
Mohamed O. Seisa ◽  
Allison S. Morrow ◽  
Oscar J. Ponce ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Data Extraction ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Weighted Mean ◽  
Nonsignificant Increase ◽  
American Society ◽  
October 17 ◽  
American Society Of Anesthesiologists

To evaluate the effectiveness of an admixture of ketamine and propofol on peri-induction hemodynamics during airway manipulation, we searched electronic databases of randomized controlled trials from January 1, 2000, to October 17, 2018. Trial screening, selection, and data extraction were done independently by two reviewers with outcomes pooled across included trials using the random-effects model. We included 10 randomized trials (722 patients, mean age of 53.99 years, 39.96% female). American Society of Anesthesiologists physical status was reported in 9 trials with classes I and II representing the majority. Ketamine/propofol admixture was associated with a nonsignificant increase in heart rate (weighted mean difference, 3.36 beats per minute (95% CI, −0.88, 7.60), I2 = 88.6%), a statistically significant increase in systolic blood pressure (weighted mean difference, 9.67 mmHg (95% CI, 1.48, 17.86), I2 = 87.2%), a nonsignificant increase in diastolic blood pressure (weighted mean difference, 2.18 mmHg (95% CI, −2.82, 7.19), I2 = 73.1%), and a nonsignificant increase in mean arterial pressure (weighted mean difference, 3.28 mmHg (95% CI, −0.94, 7.49), I2 = 69.9%) compared to other agents. The risk of bias was high and the certainty of evidence was low. In conclusion, among patients undergoing airway manipulation and needing sedation, the use of a ketamine/propofol admixture may be associated with better hemodynamics compared to nonketamine/propofol sedation. This trial is registered with CRD42019125725.

Relaxation Therapy for Hypertension: Design Effects and Treatment Effects2

1991 ◽  
Vol 13 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Rolf G. Jacob ◽  
Margaret A. Chesney ◽  
David M. Williams ◽  
Yijun Ding ◽  
Alvin P. Shapiro
Keyword(s):  
Blood Pressure ◽  
Outcome Measurement ◽  
Meta Analysis ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Relaxation Effect ◽  
Treatment Modalities ◽  
Relaxation Therapy ◽  
Pre Treatment ◽  
Treatment Pressure

Abstract The outcome literature on relaxation therapy for hypertension is surveyed and compared with the results of a recent meta-analysis, the Hypertension Intervention Pooling Project (HIPP). The results in the literature appear more favorable than those obtained in the HIPP. It seems that different impressions regarding the efficacy of relaxation therapy are reached depending on whether all studies or only methodologically sophisticated studies are examined. Besides pre-treatment pressure, the effect of baseline entry characteristics of a study were found to affect outcome: the largest declines in systolic pressure were reported in studies that included only one baseline session and used patients who were new to the outcome measurement setting. Comparing the changes of blood pressure in response to different treatment modalities yielded few differences once the effects of pre-treatment pressure and baseline entry characteristics had been considered; nevertheless, further research might be indicated to assess the effect of stress- or anxiety-management and EMG-biofeedback-assisted relaxation, using appropriate designs. The possibility of patient characteristics predisposing to successful treatment outcome was considered, but no clear findings are available at this time. A final concern is a possible lack of generalization of the relaxation effect outside of the blood pressure measurement situation; the declines in blood pressure observed with relaxation therapy may be transient and specific for the measurement situation.

Puerarin for OVX-Induced Postmenopausal Osteoporosis in Murine Model: Systematic Review and Meta-Analysis

2020 ◽  
Vol 15 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Xiaobin Yang ◽  
Haishi Zheng ◽  
Yuan Liu ◽  
Dingjun Hao ◽  
Baorong He ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Mass ◽  
Postmenopausal Osteoporosis ◽  
Murine Model ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Weighted Mean ◽  
Enhancing Effect ◽  
Searching Strategy

Aims/Background: Ovariectomy (OVX)-induced murine model is widely used for postmenopausal osteoporosis study. Our current study was conducted to systematically review and essentially quantified the bone mass enhancing effect of puerarin on treating OVX-induced postmenopausal osteoporosis in murine model. Methods: Literatures from PUBMED, EMBASE, and CNKI were involved in our searching strategy by limited the inception date to January 9th, 2019. Moreover, the enhancing effect of puerarin on bone mass compared to OVX-induced rats is evaluated by four independent reviewers. Finally, all the data were extracted, quantified and analyzed via RevMan, besides that in our current review study, we assessed the methodological quality for each involved study. Results: Based on the searching strategy, eight randomization studies were finally included in current meta-analysis and systematic review. According to the data analysis by RevMan, puerarin could improve bone mineral density (BMD); (eight studies, n=203; weighted mean difference, 0.05; 95% CI, 0.03-0.07; P<0.0001) using a random-effects model. There is no significant difference between puerarin and estrogen (seven studies, n=184; weighted mean difference, 0.00; 95% CI, -0.01 to 0.00; P=0.30). Conclusions: Puerarin showed upregulating effects on bone mass in OVX-induced postmenopausal osteoporosis in murine model. More studies of the effect of puerarin on bone density in OVX animals are needed.

scholarly journals Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110327
Author(s):  
Weihua Liu ◽  
Wenli Yu ◽  
Hongli Yu ◽  
Mingwei Sheng
Keyword(s):  
Clinical Efficacy ◽  
Lower Risk ◽  
Gastrointestinal Endoscopy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Similar Efficacy ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Inclusion Criteria ◽  
Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

Effects of cinnamon supplementation on systolic and diastolic blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials

2021 ◽  
Author(s):  
Zeinab Yazdanpanah ◽  
Mandana Amiri ◽  
Azadeh Nadjarzadeh ◽  
Hadis Hooshmandi ◽  
Maryam Azadi-Yazdi
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Diastolic Blood Pressure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Controlled Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

Introduction: Hypertension is a chronic condition that might lead to renal and cardiovascular diseases. The previous trials examining the effect of cinnamon supplementation on blood pressure have led to conflicting results. The present systematic review aimed to summarize the effect of cinnamon supplementation on blood pressure using a meta-analysis of published randomized controlled clinical trials. Methods: To identify the eligible articles, MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched from inception until September 2019 for relevant articles. The risk of bias assessment was performed using the Cochrane collaboration tool. A Random-effects model was applied to calculate the summary effects. Results: Totally, 11 trials with 686 participants were included in this systematic review and meta-analysis. The dose of cinnamon supplement consumption varied from 500 to 10000 mg/d. The meta-analysis revealed that cinnamon supplementation significantly decreases systolic blood pressure (SBP) [WMD (weighted mean difference)= -5.72 mmHg, 95% confidence interval (CI): -8.63 to -2.80; P<0.001, I2= 81.1)] and diastolic blood pressure (DBP) (WMD= -4.06 mmHg, 95% CI: -6.68 to -1.44; P= 0.002, I2 = 88.6). Subgroup analysis suggested no significant reduction of DBP in subjects with diabetes (WMD= -2.015 mmHg, 95% CI: -4.55 to 0.52; P= 0.12, I2 = 72.3) and prediabetes or metabolic syndrome (WMD= -4.8 mmHg, 95% CI: -10.06 to 0.44; P= 0.073, I2= 92.5). Conclusions: Cinnamon supplementation could be beneficial in lowering SBP and DBP in adults. Further studies with different doses are recommended to confirm the present findings.

scholarly journals Effect of Earthworm on Wound Healing: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dong Wang ◽  
Zhen Ruan ◽  
Rongchao Zhang ◽  
Xuejing Wang ◽  
Ruihui Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Healing Rate ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Healing Process ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Cochrane Library ◽  
Weighted Mean

Background: Earthworm, also called dilong (Chinese language), has been used as a traditional Chinese medicine for thousands of years. Recently, some scientists believe that earthworm extracts (EE) can promote wound healing. However, its effectiveness remains controversial. We conducted a meta-analysis to evaluate the effect of EE on wound healing based on the healing rate.Methods: We comprehensively reviewed literature that mentioned EE for wound healing in the PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP database for Chinese Technical Periodicals, and WanFang database that have been published until January 2021. We computed weighted mean difference (WMD) for analysis with RevMan 5.3 software in animal and human models groups. Two researchers independently selected studies and evaluated the risk of bias with the Cochrane Collaboration tool. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42020168400).Results: From 2,486 articles, we selected 16 studies for analysis. EE treatment was associated with improvements in wound healing performance based on wound healing rate (mouse model: weighted mean difference (WMD) = 3.55, 95% confidence interval (CI): 2.34–4.77, p &lt; 0.00001; rat model: WMD = 17.29, 95% CI: 5.75–28.82, p = 0.003; rabbit model: WMD = 19.29, 95% CI: 9.95–28.64, p &lt; 0.0001). Clinical studies also confirmed that EE could reduce healing time in hospital (WMD = −8.94, 95% CI: −17.75 to −0.14, p = 0.05).Conclusion: The results of this meta-analysis demonstrated the efficacy of EE on wound healing process. As a corollary, EE can be a useful natural product for wound healing drug development.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168400, identifier CRD42020168400.

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