scholarly journals SGLT2 inhibitors and lower limb complications: an updated meta‐analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chu Lin ◽  
Xingyun Zhu ◽  
Xiaoling Cai ◽  
Wenjia Yang ◽  
Fang Lv ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Lower Limb ◽  
Blood Pressure Reduction ◽  
Random Effect Model ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Pressure Reduction ◽  
Effect Model ◽  
Meta Regression

Abstract Background To exam the associations between the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) and the risk of lower limb complications, and to analyze the associated factors. Methods Pubmed, Medline, Embase, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from the inception to November 2020. Randomized controlled trials of SGLT2i conducted in population containing diabetic patients with reports of amputation, peripheral arterial disease (PAD) and diabetic foot (DF) events were included. Random-effect model, fixed-effect model and meta-regression analysis were accordingly used. Result The numbers of SGLT2i users versus non-SGLT2i users in the analyses of amputation, PAD and DF were 40,925/33,414, 36,446/28,685 and 31,907/25,570 respectively. Compared with non-SGLT2i users, the risks of amputation and PAD were slightly increased in patients with canagliflozin treatment (amputation: OR = 1.60, 95% CI 1.04 to 2.46; PAD: OR = 1.53, 95 % CI 1.14 to 2.05). Meta-regression analyses indicated that greater weight reduction in SGLT2i users was significantly associated with the increased risks of amputation (β = − 0.461, 95% CI − 0.726 to − 0.197), PAD (β = − 0.359, 95% CI − 0.545 to − 0.172) and DF (β = − 0.476, 95% CI − 0.836 to − 0.116). Lower baseline diastolic blood pressure (β = − 0.528, 95% CI − 0.852 to − 0.205), more systolic blood pressure reduction (β = − 0.207, 95% CI − 0.390 to − 0.023) and more diastolic blood pressure reduction (β = − 0.312, 95% CI − 0.610 to − 0.015) were significantly associated with the increased risks of amputation, PAD and DF respectively in patients with SGLT2i treatment. Conclusions The risks of amputation and PAD were slightly increased in patients with canagliflozin treatment. Reductions in body weight and blood pressure were associated with lower limb complications in patients with SGLT2i treatment.

Self-management of hypertension: Predictors of success in diastolic blood pressure reduction

1988 ◽  
Vol 11 (2) ◽  
pp. 105-115 ◽  
Author(s):  
Helen Nakagawa-Kogan ◽  
Annabaker Garber ◽  
Monica Jarrett ◽  
Kelly J. Egan ◽  
Susan Hendershot
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
Self Management ◽  
Pressure Reduction ◽  
Predictors Of Success

scholarly journals Chronic Disease Management Programs Based On Caring Theory With Blood Pressure Reduction

2021 ◽  
Vol 5 (1) ◽  
pp. 70-76
Author(s):  
Apriyani Puji Hastuti ◽  
Ardhiles Wahyu Kurniawan ◽  
Hanim Mufarokhah
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Disease Management ◽  
Diastolic Blood Pressure ◽  
Chronic Disease Management ◽  
Blood Pressure Reduction ◽  
Management Program ◽  
Pressure Reduction ◽  
Cross Sectional ◽  
Disease Management Programs

Background: Hypertension cases to overcome the patient's hypertension condition would be well or prosperous condition and the patient could prevent complications and control blood pressure. Activities in Chronic Disease Management Program (Prolanis) include medical or educational consultations, home visits, reminders, club activities.Purpose: This study aimed to analyze the application of the prolanis program based on the caring theory by reducing blood pressure in hypertensive patients.Methods: The design of this research is pre-experimental with cross sectional study approach. The population in this study were all patients with hypertension who took part in management program activities in the public health center (PHC), a number of 40 people, with the sampling technique used was accidental sampling and the total sample was 28 people. The data collection method used a questionnaire. The data analysis of this research is to use the Paired t test.Results: The result of this study is that there is a relationship between the application of a chronis disease management programs based on caring theory with blood pressure reduction with an average systolic blood pressure before the intervention of 142?26.15 and after the intervention of 138?1.21 with p= 0.000 which means that the module intervention can decrease systolic and diastolic blood pressure. While for diastolic blood pressure, the results of the study showed that the mean blood pressure before the intervention was 85?10.36 and after the intervention was 85?7.61 with p= 0.000.Conclusion: It can be concluded that there is a possitive effect between giving prolanis module based on caring theory with systolic and diastolic blood pressure

Abstract P013: Meta-analysis of Poor Outcomes and Permissive Hypertension after Acute Ischemic Stroke

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Alexander Ivanov ◽  
Ambreen Mohamed ◽  
Alex Korniyenko
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Blood Pressure Reduction ◽  
Random Effect ◽  
Random Effect Model ◽  
Pressure Reduction ◽  
Antihypertensive Medications ◽  
All Cause Mortality

Background: Stroke is the leading cause of long term disability and second leading cause of death worldwide. The effectiveness of primary and secondary prevention of stroke by antihypertensive medications is well validated, however, support for permissive hypertension in the early course of acute ischemic stroke (AIS) has been questioned. Materials and methods: We searched Pubmed, Embase, and Cochrane databases to identify RCTs comparing different blood pressure reduction regimens with placebo in AIS patients within 48 hours after symptom onset and sample size of 100 or more patients. We excluded studies that do not report mortality or functional outcomes at the end of follow up. The main outcomes were all-cause mortality and death or severe morbidity which was defined as: modified Rankin Score >2 or Bartel ADL index<60, Glasgow outcome scale3, Mathew Impairment Scale <14. Relative risks (RR) and corresponding 95% confidence intervals (CI) were calculated using random-effect model. Results: In our analysis we included 20 trials involving 17,209 patients. There was no difference in all-cause mortality RR 1.04 (95% CI 0.95-1.13), p=0.4 nor in mortality or severe disability RR 1.03 (95% CI 0.99-1.08), p=0.16 between active blood pressure reduction and permissive hypertension strategy. There was no evidence of heterogeneity between studies for both outcomes I 2 =2.6% and I 2 =14.1% , p for heterogeneity =0.42 and =0.27, respectively. Conclusion: Use of antihypertensive therapy in acute period of ischemic stroke does not have an effect on disability or all-cause mortality.

scholarly journals A meta-analysis of randomized controlled trials of azilsartan therapy for blood pressure reduction

2013 ◽  
Vol 37 (5) ◽  
pp. 432-437 ◽  
Author(s):  
Hisato Takagi ◽  
◽  
Yusuke Mizuno ◽  
Masao Niwa ◽  
Shin-nosuke Goto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Blood Pressure Reduction ◽  
Controlled Trials ◽  
Pressure Reduction ◽  
Randomized Controlled

A prospective comparative study to examine the effects of oral diazepam on blood pressure and anxiety levels in patients with acute epistaxis

2006 ◽  
Vol 121 (2) ◽  
pp. 124-129 ◽  
Author(s):  
J F Thong ◽  
S Lo ◽  
R Houghton ◽  
V Moore-Gillon
Keyword(s):  
Blood Pressure ◽  
Comparative Study ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Elevated Blood ◽  
Prospective Comparative Study ◽  
The Difference ◽  
Oral Diazepam

Objective: To examine the effects of oral diazepam on blood pressure and anxiety in patients with acute epistaxis.Study design and setting: A prospective comparative study in an otorhinolaryngology tertiary referral centre.Participants: Patients with acute epistaxis requiring hospital admission.Intervention: Oral diazepam.Main outcome measures: Anxiety and blood pressure levels.Results: 32 patients received diazepam and 45 did not (control). On average, patients were hypertensive on admission (mean [standard deviation (SD)] systolic blood pressure diazepam group=157 mmHg [26], control=152 mmHg [23]; diastolic blood pressure diazepam group=87 mmHg [16], control=87 mmHg [18]). Both groups showed significant blood pressure reduction on discharge (p<0.0001) but the difference in mean blood pressure reduction between the two groups was insignificant (systolic blood pressure p=0.16, 95% confidence interval [CI]=–5 to +19 mmHg; diastolic blood pressure p=0.43, 95% CI=–8 to +10 mmHg). Anxiety was significantly lower on discharge (p<0.0001) but the difference in mean fall in anxiety scores between the two groups was insignificant (p=0.08, 95% CI=0 to +2). There was no significant correlation between total diazepam and changes in blood pressure (systolic blood pressure p=0.32; diastolic blood pressure p=0.65) or anxiety (p=0.73), nor between blood pressure and anxiety on admission (systolic blood pressure p=0.45; diastolic blood pressure p=0.72).Conclusions: Elevated blood pressure and anxiety in acute epistaxis patients reduced on epistaxis resolution irrespective of oral diazepam use. The elevated blood pressure does not appear to be directly related to anxiety.

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