scholarly journals Do toe blood pressures predict healing after minor lower limb amputation in people with diabetes? A systematic review and meta-analysis

2020 ◽  
Vol 17 (3) ◽  
pp. 147916412092886
Author(s):  
Clare Linton ◽  
Angela Searle ◽  
Fiona Hawke ◽  
Peta Ellen Tehan ◽  
Mathew Sebastian ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Relative Risk ◽  
Systolic Blood Pressure ◽  
Meta Analysis ◽  
Limb Amputation ◽  
Cochrane Library ◽  
Amputation Level ◽  
Pressure Index ◽  
Blood Pressures ◽  
The Cochrane Library

Purpose of study: To investigate toe systolic blood pressure and/or toe-brachial pressure index in predicting healing post minor diabetic foot amputations. Key methods: A systematic search of EMBASE and PubMed (including Medline and The Cochrane Library) was conducted from database inception to 9 March 2020. Two authors independently reviewed and selected relevant studies. Quality was assessed with a modified Critical Appraisal Skill Programme checklist. Main results: Ten studies met the inclusion criteria. Nine studies investigating toe systolic blood pressure reported healing occurred at mean toe systolic blood pressure values ⩾30 mmHg, ranging between 30 and 83.6 mmHg. The meta-analysis (four studies) found toe systolic blood pressure <30 mmHg had 2.09 times the relative risk of non-healing post amputation, compared to toe systolic blood pressure ⩾30 mmHg (relative risk = 2.09, 95% confidence interval: 1.37–3.20, p = 0.001). Two studies investigating toe-brachial pressure index report successful healing where toe-brachial pressure index >0.2, with one study reporting a higher value of 0.8. Main conclusions: Successful post-amputation healing outcomes were reported at mean toe systolic blood pressure ⩾30 mmHg, and the results varied considerably between the studies. Further research should identify whether variables, including amputation level, method of wound closure and length of post-operative follow-up periods, affect the values of toe systolic blood pressure and toe-brachial pressure index observed in this review.

scholarly journals Blood Pressure Variability and Prognosis in Hemodialysis Patients: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-14
Author(s):  
Yuliang Zhao ◽  
Letian Yang ◽  
Shaobin Yu ◽  
Stephen Salerno ◽  
Yi Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cardiovascular Mortality ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Meta Analysis ◽  
Cochrane Library ◽  
All Cause Mortality ◽  
The Cochrane Library ◽  
Stratified Analysis

<b><i>Background:</i></b> The prognostic value of blood pressure variability (BPV) in patients receiving hemodialysis is inconclusive. In this study, we aimed to assess the association between BPV and clinical outcomes in the hemodialysis population. <b><i>Methods:</i></b> Pubmed/Medline, EMBASE, Ovid, the Cochrane Library, and the Web of Science databases were searched for relevant articles published until April 1, 2020. Studies on the association between BPV and prognosis in patients receiving hemodialysis were included. <b><i>Results:</i></b> A total of 14 studies (37,976 patients) were included in the analysis. In patients receiving hemodialysis, systolic BPV was associated with higher all-cause (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 1.07–1.19; <i>p</i> &#x3c; 0.001) and cardiovascular (HR: 1.16; 95% CI: 1.10–1.22; <i>p</i> &#x3c; 0.001) mortality. In the stratified analysis of systolic BPV, interdialytic systolic BPV, rather than 44-h ambulatory systolic BPV or intradialytic systolic BPV, was identified to be related to both all-cause (HR: 1.11; 95% CI: 1.05–1.17; <i>p</i> = 0.001) and cardiovascular (HR: 1.14; 95% CI: 1.06–1.22; <i>p</i> &#x3c; 0.001) mortality. Among the different BPV metrics, the coefficient of variation of systolic blood pressure was a predictor of both all-cause (<i>p</i> = 0.01) and cardiovascular (<i>p</i> = 0.002) mortality. Although diastolic BPV was associated with all-cause mortality (HR: 1.09; 95% CI: 1.01–1.17; <i>p</i> = 0.02) in patients receiving hemodialysis, it failed to predict cardiovascular mortality (HR: 0.86; 95% CI: 0.52–1.42; <i>p</i> = 0.56). <b><i>Conclusions:</i></b> This meta-analysis revealed that, in patients receiving hemodialysis, interdialytic systolic BPV was associated with both increased all-cause and cardiovascular mortality. Furthermore, the coefficient of variation of systolic blood pressure was identified as a potentially promising metric of BPV in predicting all-cause and cardiovascular mortality. The use of 44-h ambulatory systolic BPV, intradialytic systolic BPV, and metrics of diastolic BPV in the prognosis of the hemodialysis population require further investigation (PROSPERO registry number: CRD42019139215).

scholarly journals Influence of Mindfulness and Relaxation on Treatment of Essential Hypertension: Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fushun Zhang ◽  
Yuanyuan Zhang ◽  
Nan Jiang ◽  
Qiao Zhai ◽  
Juanjuan Hu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Publication Bias ◽  
Effect Size ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Control Group ◽  
Effect Model

Background. Some studies published previously have shown a strong correlation between hypertension and psychological nature including impulsion emotion or mindfulness and relaxation temperament, among which mindfulness and relaxation temperament might have a benign influence on blood pressure, ameliorating the hypertension. However, the conclusion was not confirmed. Objective. The meta-analysis was performed to investigate the influence of mindfulness and relaxation on essential hypertension interventions and confirm the effects. Methods. Systematic searches were conducted in common English and Chinese electronic databases (i.e., PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, Cochrane Library, and Chinese Biomedical Literature Database) from 1980 to 2020. A meta-analysis including 5 studies was performed using Rev Man 5.4.1 software to estimate the influence of mindfulness and relaxation on blood pressure, ameliorating the hypertension. Publication bias and heterogeneity of samples were tested using a funnel plot. Studies were analyzed using either a random-effect model or a fixed-effect model. Results. All the 5 studies investigated the influence of mindfulness and relaxation on diastolic and systolic blood pressure, with total 205 participants in the control group and 204 in the intervention group. The random-effects model (REM) was used to calculate the pooled effect for mindfulness and relaxation on diastolic blood pressure (I2 = 0%, t2 = 0.000, P = 0.41 ). The random pooled effect size (MD) was 0.30 (95% CI = −0.81–1.42, P = 0.59 ). REM was used to calculate the pooled effect for mindfulness and relaxation on systolic blood pressure (I2 = 49%, t2 = 3.05, P = 0.10 ). The random pooled effect size (MD) was −1.05 (95% CI = −3.29–1.18, P = 0.36 ). The results of this meta-analysis were influenced by publication bias to some degree. Conclusion. All the results showed less influence of mindfulness and relaxation might act on diastolic or systolic blood pressure, when mindfulness and relaxation are used to intervene in treating CVD and hypertension.

scholarly journals Association between Serum Vitamin C and the Blood Pressure: A Systematic Review and Meta-Analysis of Observational Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Li Ran ◽  
Wenli Zhao ◽  
Xiaodong Tan ◽  
Hongwu Wang ◽  
Kaito Mizuno ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin C ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Inverse Correlation ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
English Articles

Background. Hypertension is regarded as a major and independent risk factor of cardiovascular diseases, and numerous studies observed an inverse correlation between vitamin C intake and blood pressure. Aim. Our aim is to investigate the relationship between serum vitamin C and blood pressure, including the concentration differences and the correlation strength. Method. Two independent researchers searched and screened articles from the National Library of Medicine, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP databases, and WANFANG databases. A total of 18 eligible studies were analyzed in the Reviewer Manager 5.3 software, including 14 English articles and 4 Chinese articles. Results. In the evaluation of serum vitamin C levels, the concentration in hypertensive subjects is 15.13 μmol/L lower than the normotensive ones (mean difference=−15.13, 95% CI [-24.19, -6.06], and P=0.001). Serum vitamin C has a significant inverse relation with both systolic blood pressure (Fisher’s Z=−0.17, 95% CI [-0.20, -0.15], P<0.00001) and diastolic blood pressure (Fisher’s Z=−0.15, 95% CI [-0.20, -0.10], P<0.00001). Conclusions. People with hypertension have a relatively low serum vitamin C, and vitamin C is inversely associated with both systolic blood pressure and diastolic blood pressure.

Effects of aerobic exercise on obese children with metabolic syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Youxiang Cao ◽  
Lin Zhu ◽  
Jingxin Liu
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Aerobic Exercise ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Exercise Group ◽  
Cochrane Library ◽  
Obese Children ◽  
Meta Analyses ◽  
The Cochrane Library

Abstract Objectives Metabolic syndrome (MetS) is systemic metabolic disease that results from insulin resistance or obesity. Numerous meta-analyses have investigated the effect of exercise on different populations, but none were aimed at the effect of aerobic exercise alone on obese children. This review systematically assessed and performed a meta-analysis on the effect of aerobic exercise on obese children with MetS. Content MEDLINE via PubMed, Embase, SPORTDiscus, and the Cochrane library were searched and screened from inception to 20 October 2020 for randomized controlled trials. The inclusion criteria were obese children who met the criteria for MetS and aged 5–19 years old in an aerobic exercise group. The meta-analysis included eight trials with a total of 197 participants. Aerobic exercise significantly improved the waist circumference (mean difference [MD]=−3.97; 95% confidence interval [CI]=−6.12 to −1.83; p<0.01), body mass index (standardized MD [SMD]=−0.5; 95% CI=−0.70 to −0.29; p<0.01), triglyceride (SMD=−24.6; 95% CI=−33.85 to −15.35; p<0.01), high-density lipoprotein cholesterol (SMD=2.36; 95% CI=0.44 to 4.27; p<0.01), and systolic blood pressure (SMD=−6.90; 95% CI=−10.46 to −3.35; p<0.01). Summary Based on the results of this meta-analysis, during the intervention period of the included studies, aerobic exercise alone mainly affected the lipoprotein, blood pressure, and body dimensions but cannot completely cure the MetS of obese children. Outlook The effects of different types of aerobic exercise on obese children with MetS and exercise dose to cure the MetS of obese children needs to be further studied.

Selective versus non-selective alpha-blockade prior to adrenalectomy for pheochromocytoma – systematic review and meta-analysis

2021 ◽  
Author(s):  
Karolina Zawadzka ◽  
Krzysztof Więckowski ◽  
Piotr Małczak ◽  
Michał Wysocki ◽  
Piotr Major ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Preoperative Treatment ◽  
Adrenergic Blockade ◽  
Alpha Blockers ◽  
Alpha Blockade ◽  
Sympathetic Paraganglioma

Objective: Alpha-adrenergic blockade is currently the first choice of preoperative treatment in patients with functional pheochromocytoma and sympathetic paraganglioma. Nevertheless, there is no consensus whether selective or non-selective alpha-blockade is superior for preventing both perioperative hemodynamic instability and complications. Design: Our study aimed to compare selective and non-selective alpha-blockade through a systematic review with meta-analysis. Methods: MEDLINE, Embase, Web of Science and Cochrane Library were searched for eligible studies. Randomized and observational studies comparing selective and non-selective alpha-blockade in pheochromocytoma and sympathetic paraganglioma surgery in adults were included. Data on perioperative hemodynamic parameters and postoperative outcomes were extracted. Results: Eleven studies with 1,344 patients were enrolled. Patients receiving selective alpha-blockade had higher maximum intraoperative systolic blood pressure (WMD 12.14 mm Hg, 95% CI 6.06-18.21, p<0.0001) compared to those treated with non-selective alpha-blockade. Additionally, in the group pretreated with selective alpha-blockers, intraoperative vasodilators were used more frequently (OR 2.46, 95% CI 1.44-4.20, p=0.001). Patients treated with selective alpha-blockers had lower minimum intraoperative systolic blood pressure (WMD -2.03 mmHg, 95% CI -4.06 to -0.01, p=0.05) and shorter length of hospital stay (WMD -0.58 days, 95% CI -1.12 to -0.04, p=0.04). Operative time, overall morbidity and mortality did not differ between the groups. Conclusions: This meta-analysis shows non-selective alpha-blockade was more effective in preventing intraoperative blood pressure fluctuations while maintaining comparable risk of both intraoperative and postoperative hypotension and overall morbidity.

scholarly journals Comparison of Intravenous Dexmedetomidine versus Esmolol for Attenuation of Hemodynamic Response to Tracheal Intubation after Rapid Sequence Induction: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Zhao Li ◽  
Li Xu ◽  
Jinwei Zheng ◽  
Qingxiu Wang
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Tracheal Intubation ◽  
Meta Analysis ◽  
Rapid Sequence Induction ◽  
Hemodynamic Response ◽  
Cochrane Library ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
The Cochrane Library

The present study aims to investigate whether intravenous dexmedetomidine shows superiority to esmolol for hemodynamic response to tracheal intubation after rapid sequence induction. In the present meta-analysis, PubMed, EMBASE, and the Cochrane Library were searched for trials comparing dexmedetomidine with esmolol for the attenuation of the hemodynamic response to intubation. Ten trials were selected in the present meta-analysis. Compared to esmolol, the use of dexmedetomidine maintains stable heart rates (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) at 1 min, 3 min, and 5 min after tracheal intubation. Dexmedetomidine causes less hemodynamic response to tracheal intubation after rapid sequence induction compared with esmolol.

scholarly journals Effects of Multivitamin and Multimineral Supplementation on Blood Pressure: A Meta-Analysis of 12 Randomized Controlled Trials

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1018 ◽  
Author(s):  
Kelei Li ◽  
Chunxiao Liu ◽  
Xiaotong Kuang ◽  
Qingxue Deng ◽  
Feng Zhao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Systolic Blood Pressure ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Lowering Effect ◽  
Normotensive Subjects

Previous studies have not drawn a consistent conclusion about effect of multivitamin and multimineral supplementation (MVMS) on blood pressure. A comprehensive search of PubMed, Embase and Cochrane Library (up to May 2018) and references of relevant articles was undertaken. The present meta-analysis included 12 randomized controlled trials (RCTs), of which eight RCTs in 2011 subjects evaluated the effect of MVMS on blood pressure and four RCTs in 21,196 subjects evaluated the effect of MVMS on the risk of hypertension. MVMS had a lowering effect on systolic blood pressure (SBP) and diastolic blood pressure (DBP): the weighted mean difference (WMD) was −1.31 mmHg (95% CI, −2.48 to −0.14 mmHg) and −0.71 mmHg (95% CI, −1.43 to 0.00 mmHg), respectively. Subgroup analysis indicated that the lowering effect of MVMS on blood pressure was only significant in 134 subjects with chronic disease but not in 1580 healthy subjects, and the WMD for systolic blood pressure (SBP) and DBP in subjects with chronic disease was −6.29 mmHg (95% CI, −11.09 to −1.50 mmHg) and −2.32 mmHg (95% CI, −4.50 to −0.13 mmHg), respectively. The effect size of MVMS on SBP in 58 hypertensive subjects (WMD, −7.98 mmHg; 95% CI, −14.95 to −1.02 mmHg) was more than six times of that in 1656 normotensive subjects (WMD, −1.25 mmHg; 95% CI, −2.48 to −0.02 mmHg). However, no significant effect on DBP was observed in both hypertensive and normotensive subgroups. There was no significant effect of MVMS on risk of hypertension in 22,852 subjects with a normal blood pressure at baseline. In conclusion, although MVMS had a significant lowering effect on blood pressure in normotensive subjects, the lowering effect was too small to effectively prevent future hypertension. MVMS may be an effective method for blood pressure control in subjects with chronic disease including hypertension, but the sample size of subjects with hypertension or other chronic disease was too small, and more well-designed RCTs are needed to confirm this result.

scholarly journals 5-HT3 receptor antagonists for the prevention of postoperative shivering: a meta-analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 1174-1181 ◽  
Author(s):  
Chengmao Zhou ◽  
Yu Zhu ◽  
Zhen Liu ◽  
Lin Ruan
Keyword(s):  
Relative Risk ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Comparable Efficacy ◽  
Controlled Trials ◽  
Receptor Antagonists ◽  
Exclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Cochrane Library

Objective We evaluated the efficacy of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Methods We searched PubMed, the Cochrane Library, EMBASE and Web of Knowledge to find randomized controlled trials (RCT) of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Two researchers independently screened studies, extracted data, and assessed quality in accordance with the inclusion and exclusion criteria, and then conducted a meta-analysis using RevMan 5.2. Results Ultimately, 14 RCTs that included 980 patients were included in the analysis. We found that: 1) the incidence of shivering was significantly lower in 5-HT3 groups than placebo groups (relative risk, [RR] = 0.48, 95% confidence interval [CI] 0.40 – 0.58); 2) there was no significant difference in the incidence of shivering between 5-HT3 groups and meperidine groups (RR = 0.89, 95% CI 0.60 – 1.34). Conclusion 5-HT3 receptor antagonists appear to prevent postoperative shivering, with a broadly comparable efficacy to meperidine.

scholarly journals Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Gianfranco Parati ◽  
Sverre Kjeldsen ◽  
Antonio Coca ◽  
William C. Cushman ◽  
Jiguang Wang
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Single Pill ◽  
Discontinue Therapy ◽  
The Cochrane Library

Poor adherence to antihypertensive therapy is a major cause of poor blood pressure (BP) control in patients with hypertension. Regimen simplification may improve adherence and BP control. This systematic review assessed whether single-pill combination (SPC) therapy led to improved adherence, persistence, and better BP control compared with free-equivalent combination (FEC) therapy in patients with hypertension. PubMed, Medline, Embase, and the Cochrane Library were searched until July 2020, in addition to manual searching of relevant congress abstracts from 2014 to 2020 for studies including adults with hypertension aged ≥18 years receiving SPC or FEC antihypertensive therapy measuring any of the following: adherence, persistence, and reductions in systolic BP and/or diastolic BP. Adherence and persistence were summarized in a narrative analysis; direct pair-wise meta-analysis was conducted to compare BP reductions with SPC therapy versus FEC therapy using fixed-effect and random-effects models. Following screening, 44 studies were included. The majority (18 of 23) of studies measuring adherence showed adherence was significantly improved in patients receiving SPCs versus FECs. Overall, 16 studies measured persistence, of which 14 showed that patients receiving SPCs had significantly improved persistence or were significantly less likely to discontinue therapy than patients receiving FECs. Systolic BP (mean difference, −3.99 [95% CI, −7.92 to −0.07]; P =0.05) and diastolic BP (−1.54 [95% CI, −2.67 to −0.41]; P =0.0076) were both significantly reduced with SPC therapy compared with FEC therapy at week 12. SPC therapy leads to improved adherence and persistence compared with FEC therapy and may lead to better BP control in patients with hypertension.

scholarly journals Tekanan darah siswa sekolah dasar obes dan tidak obes di Kota Yogyakarta

2009 ◽  
Vol 6 (2) ◽  
pp. 60
Author(s):  
Emy Huriyati ◽  
Madarina Julia
Keyword(s):  
Blood Pressure ◽  
Relative Risk ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Task Force ◽  
Blood Pressures ◽  
Age And Sex

Background: In adulthood, obesity is related to the increasing of mortality risk as the effect of cardiovascular diseases. Adulthood obesity is often started from childhood. Besides obesity causes, risk of cardiovascular are influenced by blood pressure as well.Objective: The study was proposed to compare blood pressure of obese and non-obese students.Method: The study was conducted among 52 obese and 52 non-obese students aged 9–12 years old matched with age and sex. Subjects were obtained through obesity screening among obese students. The criteria of obesity were BMI to age in or over 95 percentage of CDC 2000 standard. Blood pressure was measured three times at three different days with quicksilver sphygmomanometer. Its method was adjusted to Task Force on Blood Pressure in Children instruction.Results: Mean of systolic blood pressure of obese students was 109.2 (6.0) mmHg, higher than non-obese, 89.4 (6.9) mmHg. The different mean (CI 95%) of systolic blood pressure of both group was 19.9 (17.3-22.4) mmHg, p < 0.001. Mean of diastolic blood pressure of obese students was 72.4 (4.9) mmHg, while non-obese was 58.1 (8.1) mmHg. The different mean (CI 95%) of diastolic blood pressure of both group was 14.3 (11.6-16.9) mmHg, p < 0.001. Obese students had relative risk of systolic blood pressure (CI 95%) 22.5 (5.8-88.0) times higher than non-obese students. Relative risk of diastolic blood pressure of obese students (CI 95%) was 3.7 (2.4-5.8) times higher than that of non-obese students.Conclusion: Systolic and diastolic blood pressures of obese students were higher than that of non-obese students.

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