The AGT Epistasis Pattern Proposed a Novel Role for ZBED9 In Regulating Blood Pressure: Tehran Cardiometabolic Genetic Study (TCGS)

Abstract Backgroung: Hypertension is typically considered as the leading risk factor for cardiovascular disease. Epistasis studies may add another layer of complexity to our understanding of the genetic basis of hypertension. Methods: A nested case-control design was used on 4214 unrelated Tehran Cardiometabolic Genetic Study (TCGS) adults to evaluate 65 SNPs of previously associated genes, including ZBED9, AGT, and TNXB. The integrated effect of each gene was determined using the Sequence-based Kernel Association Test (SKAT). We used model-based multifactor dimension reduction (Mb-MDR) and entropy-based gene-gene interaction (IGENT) methods to determine interaction and epistasis patterns. Results: The integrated effect of each gene has a statistically significant association with blood pressure traits (P-value < 0.05). Single-locus analysis identified two missense variants in ZBED9 (rs450630) and AGT (rs4762) that are associated with hypertension. In the ZBED9 gene, significant local interactions were discovered. The G allele in rs450630 showed an antagonistic effect on hypertension, but interestingly, IGENT analysis revealed significant epistasis effects for different combinations of ZBED9, AGT, and TNXB loci. Conclusion: We discovered a novel interaction effect between a significant variant in an essential gene for hypertension (AGT) and a missense variant in ZBED9, which has shifted our focus to ZBED9's role in blood pressure regulation.

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PENGARUH EDUKASI MANAJEMEN DIRI TERHADAP DAN TEKANAN DARAH PASIEN HIPERTENSI DI RUANG RAWAT INAP RUMAH SANTA ELISABETH MEDAN

Elisabeth Health Jurnal ◽

10.52317/ehj.v5i1.289 ◽

2020 ◽

Vol 5 (1) ◽

pp. 104-112

Author(s):

Rusmauli Rusmauli ◽

Connie M Sianipar

Keyword(s):

Blood Pressure ◽

Management Education ◽

Healthy Diet ◽

Self Management ◽

Control Group ◽

P Value ◽

Symptom Scale ◽

Healthy Behavior ◽

Cognitive Symptom ◽

Behavior Scale

Introduction: The risk for cardiovascular disorder caused by hypertension can be forestalled and controlled by applying healthy behavior such as exercises, cognitive symptom management, healthy diet, and blood pressure monitoring. In this case, education plays an important role in increasing the control of blood pressure. The objective of the research was to identify the influence of self-management education on healthy behavior and blood pressure in hypertension patients in the Hospital Elisabeth Medan Method: The research used quasi experiment and nonequivalent control group pre-post test design. The samples for this study were 60 hypertension patients as the respondents divided into two group, 30 in the intervention group and 30 in the control group taken by consecutive sampling technique. The data were gathered by using modification instruments from Stanford University; they were exercise behavior scale, cognitive symptom scale, questionnaires on healthy diet, and digital Omron tensimeter for measuring blood pressure Result: The data were gathered by using modification instruments from Stanford University; they were exercise behavior scale, cognitive symptom scale, questionnaires on healthy diet, and digital Omron tensimeter for measuring blood pressure. Data were analyzed using descriptive statistics, Wilcoxon and Mann Whitney test. The result of the research showed that there was no influence of self-management education on exercise (p-value = 1.00 > 0.05), there was the influence of self-management education on cognitive symptom (p-value = 0.00 < 0.05), there was the influence of self-management education on healthy diet (p-value = 0.00 < 0.05), and there was the influence of self-management education on systolic and diastolic blood pressure (p-value = 0.00 < 0.05).. Discussion: The conclusion of the research was that education could increase the application of healthy behavior and controlling blood pressure in hypertension patients. The result of the research could be an input for health care to maintain and increase education in hypertension patients so that they could control their blood pressure and forestall hypertension complication.

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Massive Clonidine Ingestion with Hypertension in a 9-Month-Old Infant

PEDIATRICS ◽

10.1542/peds.72.4.500 ◽

1983 ◽

Vol 72 (4) ◽

pp. 500-502

Author(s):

Pablo Yagupsky ◽

Rafael Gorodischer

Keyword(s):

Blood Pressure ◽

Antihypertensive Drugs ◽

Complete Recovery ◽

Blocking Agent ◽

Assisted Ventilation ◽

Antagonistic Effect ◽

Arterial Blood ◽

Clonidine Poisoning ◽

Adrenergic Blockers ◽

Adrenergic Blocking

The antihypertensive drug clonidine has a double and antagonistic effect on arterial blood pressure. As a result of activation of peripheral α-adrenergic receptors, it causes a transient increase in blood pressure; by a central action it decreases sympathetic tone which results in sustained bradycardia and hypotension. Both central and peripheral effects are experimentally blocked by tolazoline, an α-adrenergic blocking agent. The toxic symptoms seen in clonidine poisoning are usually produced by the central effect. A case of severe clonidine poisoning in a 9-month-old infant is reported. The clinical picture included coma, miosis, apneic spells, bradycardia, and hypertension. Rapid and complete recovery was obtained with supportive treatment that included assisted ventilation. No adrenergic blockers or antihypertensive drugs were given. Use of tolazoline in cases of clonidine overdose in children remains controversial. Supportive measures alone may be adequate for even the most severe cases.

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Relationship of Fiber Intake, Stress Level, Physical Activity with Blood Pressure of Pre Elderly and Elderly in Lubang Buaya and Kampung Tengah

Indonesian Journal of Nutritional Science ◽

10.52023/ijns.v1i1.2461 ◽

2021 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Eti Cahya Fitrianti ◽

Sintha Fransiske Simanungkalit

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Stress Level ◽

Blood Pressure Measurement ◽

Bivariate Analysis ◽

P Value ◽

Fiber Intake ◽

Chi Square ◽

Stress Levels ◽

Chi Square Test

High blood pressure is defined as systolic blood pressure that is equal to or above 140 mm Hg or diastolic blood pressure equal to or above 90 mm Hg (JNC VIII, 2013). In 2018, the prevalence of hypertension in Indonesia is based on the characteristics of the age 45-75 years and above with an average of 58.33% (Riskesdas, 2018). The aimed of this study was to determine of fiber intake, stress levels, and physical activity with blood pressure in pre elderly and elderly at RW 03 Lubang Buaya and RW 09 Kampung Tengah, East Jakarta. This research method is observational with cross sectional approach followed by 80 respondents with simple random sampling technique Data collection was taken, namely blood pressure measurement using a Sphygmomanometer, fiber intake using the Food Recall form 2 x 24 hours (Weekend and Weekday), stress levels with the DASS-14 questionnaire, and physical activity with the Baecke questionnaire. Data processing was analyzed by univariate and bivariate using Chi-Square test. The results of bivariate analysis with chi-square test showed a significant relationship between fiber intake (p value = 0.007), stress level (p value = 0,000), and physical activity (p value = 0.022) with blood pressure. There is a relationship between fiber intake, stress level, and physical activity with blood pressure in the elderly and elderly in Lubang Buaya and Kampung Tengah.

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Reduction Blood Pressureby Neck Massage Therapy Using Virgin Coconut Oil (VCO) and Dry Cupping Therapy

Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) ◽

10.26699/jnk.v8i1.art.p019-025 ◽

2021 ◽

Vol 8 (1) ◽

pp. 019-025

Author(s):

Nurul Faidah ◽

Ni Kadek Muliawati

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Communicable Disease ◽

Massage Therapy ◽

Sampling Technique ◽

Complementary Therapy ◽

Cupping Therapy ◽

Pharmacological Therapy ◽

P Value

Hypertension is a non-communicable disease which increases every year, with the increasing incidence of Hypertension will have an impact on society, namely a decrease in health status which results in a decrease in the quality of life. Management of hypertension can be done with non-pharmacological therapy, one of the non-pharmacological therapies chosen by the community, namely complementary therapy, neck massage therapy using VCO and cupping is a complementary therapy that aims to reduce hypertension. The sampling technique used was purposive sampling. The sample in this study 16 respondents were given neck massage therapy with VCO and 16 respondents were given dry cupping therapy. The data analysis used was the Spearman rank because the data were not normally distributed. Before being given neck massage therapy with a mean VCO, systolic blood pressure was 156.25, diastolic blood pressure was 87.50 after being given a mean value of 124.38 and diastolic 81.25 with a systolic p value of 0.000 while for diastolic blood pressure of 0.008. Whereas in the group given dry cupping therapy systolic blood pressure with a mean of 158.82 and diastole a mean of 90.59, after being given dry cupping therapy, systolic blood pressure was 124.71 while diastole was 78.82 with a systolic p value of 0.000 and diastole of 0.009. The difference in blood pressure in the two interventions for the system p value was 0.968 while for diastole the p value was 0.625, which means there was no difference between the two interventions. So it can be concluded that both neck massage therapy with VCO and dry cupping therapy can reduce blood pressure in patients with hypertension.

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Abstract 57: Risk Factors For Severe Reductions In Blood Pressure After Treatment Of Severe Inpatient Hypertension

Hypertension ◽

10.1161/hyp.78.suppl_1.57 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Lama Ghazi ◽

Fan Li ◽

Eric Chen ◽

Michael Simonov ◽

Yu Yamamoto ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cohort Study ◽

Hospital Admission ◽

Antihypertensive Treatment ◽

Treatment Guidelines ◽

P Value ◽

Antihypertensive Medications ◽

Black Race ◽

Oral Medications

Background: Incident severe HTN during hospitalization is far more common than admission for HTN, however treatment guidelines are lacking. Severe inpatient HTN is poorly studied, therefore our goal is to characterize inpatients who develop severe HTN and assess BP response to antihypertensive treatment. Methods: This is a cohort study of adults admitted for reasons other than HTN and developed severe HTN within a single healthcare system. We defined severe inpatient HTN as the first documentation of BP elevation (>180 systolic or >110 diastolic) at least 1 hour after hospital admission. Treatment was defined as receiving antihypertensive medications within 6 hours of BP elevation. We studied the association between treatment and BP drop ≥30%. Results: Among 224,265 hospitalized adults, 23,147 developed severe HTN of which 40% were treated. Compared to inpatients who did not develop severe HTN, those who did were older, more commonly women and Black, and had more comorbidities. Of the treated and untreated patients, 45.5 and 46.4% had a MAP drop ≥30% (p-value= 0.2). Risk factors for severe MAP drop include older age, Black race, HTN, and diabetes. Additionally, treatment vs. no treatment and treatment with intravenous vs. oral medications were associated with greater odds of MAP drop ≥30% ( Table 1 ). Conclusion: While there was no difference in the proportion of treated and untreated patients with severe MAP reduction, after adjustment for factors independently associated with HTN we found that treatment was associated with severe BP drop. Further research is needed to phenotype inpatients with severe HTN to help establish treatment guidelines.

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Abstract P124: Repeat Manual Office Blood Pressure By A Physician Is Lower Than Automated Office Blood Pressure

Hypertension ◽

10.1161/hyp.78.suppl_1.p124 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Bryce Rhodehouse ◽

Courtney Shaver ◽

Jerry Fan ◽

Bright Izekor ◽

Clinton Jones ◽

...

Keyword(s):

Blood Pressure ◽

Vital Signs ◽

Outpatient Setting ◽

Office Blood Pressure ◽

P Value ◽

Signed Rank ◽

Significant Difference ◽

Minute Interval ◽

The Difference ◽

Automated Office Blood Pressure

Introduction: An accurate measurement of blood pressure (BP) is critical to diagnosing and treating hypertension (HTN). Manual office BP (MOBP) often results in higher readings than automated office BP (AOBP). In previous studies, a repeat MOBP by a physician resulted in a lower BP than the initial MOBP by nursing staff. We evaluated our hypothesis that a repeat MOBP by a physician is statistically equivalent to AOBP. Methods: In an ambulatory outpatient setting, patients were roomed and at least a 5-minute interval lapsed before an AOBP was performed using a Welch Allyn Connex Vital Signs Monitor. The physician was blinded to the AOBP. The physician then entered the room and obtained a MOBP with a manual aneroid sphygmomanometer. The difference between the AOBP and the MOBP was calculated. A Wilcoxon signed rank sum test was used to determine if a significant difference between AOBP and MOBP exists. Results: A total of 186 patients (112 females, 74 male) had BP measured with a mean age of 66 years. AOBP resulted in a median systolic BP (SBP) 136 mmHg (IQR 121-150 mmHg) and median diastolic BP (DBP) of 78 mmHg (IQR 72-85 mmHg). MOBP SBP had a median of 132 mmHg (IQR 120-142 mmHg) and DBP had a median of 76 mmHg (IQR 70-81 mmHg). SBP and DBP were significantly lower in the MOBP group with a mean difference between AOBP and MOBP of 4.0 and 2.7 mmHg respectively (p-value of <0.0001). Conclusions: Repeat MOBP performed by the physician resulted in a significantly lower BP compared to AOBP. The lower BP may be due to an overall longer interval between the AOBP measurement and MOBP measurement. MOBP may be a viable option for accurate diagnosis and treatment of HTN clinics without access to a AOBP machine.

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Abstract P181: Cardiac Structure is Associated with Obesity and Blood Pressure But Not Inflammation

Circulation ◽

10.1161/circ.125.suppl_10.ap181 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Robert A Palermo ◽

Samuel S Gidding ◽

Stehpanie S DeLoach ◽

Scott W Keith ◽

Bonita Falkner

Keyword(s):

Blood Pressure ◽

African American ◽

Left Ventricular Mass Index ◽

African American Adolescents ◽

Female Gender ◽

Left Ventricular ◽

P Value ◽

Cardiac Structure ◽

Z Score ◽

Pai 1

Purpose: The aim of this study was to identify risk factors associated with cardiac structure in a cohort of African American adolescents oversampled for obesity and high blood pressure (BP). Additional associations of cardiac structure with a pro-inflammatory adipokine profile (low adiponectin, elevated IL6, PAI-1 and CRP) were sought. Methods: A cross-sectional study was conducted using a two-by-two factorial design with four groups of African American adolescents based on BP (prehypertension or stage 1 hypertension=high BP) and body mass index (BMI > 95% =obese) designation. Measurements included: echocardiogram, anthropomorphics, BP (on 3 separate occasions), high sensitivity CRP and plasma adipokines (adiponectin, IL6, PAI-1). Standardized echocardiogram measurements were used to obtain left ventricular mass index (LVMI, g/m 2.7 ) and left atrial diameter index (LADI, mm/m 2 ). Ordinary least-squares regression with model selection by Mallow's Cp was used to determine if pro-inflammatory adipokine profile predicted LV mass and LA diameter in models including age, gender, BMI z-score, and systolic BP. Results: Data on 251 African American adolescents, ages 13-19, were analyzed. BMI-z score was strongly associated with a pro-inflammatory adipokine profile whereas high BP was not. Variation in LADI was significantly associated with BMI (β=0.12, p<0.01) and female gender (β=0.08, p=0.04). LVMI variation was significantly associated with BMI (β=3.53, p<0.01), age (β=0.71, p<0.01), female gender (β=-4.32, p<0.01), and systolic BP (β=0.10, p=0.03). Though significant in univariate models, inflammatory markers were not significantly associated with LADI or LVMI after BMI adjustment. Conclusions: In African American adolescents, BMI is an important determinant of LADI and LVMI. Obesity is associated with a pro-inflammatory adipokine profile but LADI and LVMI are not. Table. Regression modeling results after variable selection by Mallow C p : Left Atrium Diameter Index and Left Ventricular Mass Index (N = 251) LADI LVMI Estimate (95% CL) p-value Estimate (95% CL) p-value Age (yr) 0.00063 (-0.021, 0.023) 0.955 0.71 ( 0.18, 1.24) 0.009 Gender (F) 0.08 ( 0.01, 0.16) 0.036 −4.32 (-6.13,-2.51) <.001 BMI z-score 0.12 ( 0.08, 0.16) <.001 3.53 ( 2.66, 4.40) <.001 Systolic BP 0.0019 (-0.0017, 0.0055) 0.306 0.0952 ( 0.0085, 0.1819) 0.032

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Negative Air Pressure on Wet Cupping in Decreasing Blood Pressures in Hypertensive Patients

Nurse Media Journal of Nursing ◽

10.14710/nmjn.v7i2.15177 ◽

2018 ◽

Vol 7 (2) ◽

pp. 116

Author(s):

Budi Darmawan ◽

Diyah Fatmasari ◽

Rr. Sri Endang Pujiast

Keyword(s):

Blood Pressure ◽

Repeated Measures ◽

Community Health Centers ◽

Intervention Group ◽

Air Pressure ◽

Control Group ◽

P Value ◽

Decrease Blood Pressure ◽

Blood Pressures ◽

The Mean

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.

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