Evaluating the Situational Specificity of Relaxation in Mild Essential Hypertension

A multiple baseline across subject/settings design was employed to assess the specificity of the effects of progressive relaxation in two recently diagnosed, mild hypertensives. Relaxation was implemented successively across laboratory and home settings. In Subject 1, laboratory relaxation was associated with control over diastolic blood pressure, while in Subject 2, control over systolic pressure was observed. Improvements to normotensive levels were observed for both subjects, and the changes were maintained in both settings for Subject 2 at 6- and 12-mo. follow-up. Subject 1 discontinued her medications, relaxation, and self-monitoring of blood pressure, which was associated with an increase in blood pressure during treatment maintenance; however, at 6- and 12-mo. follow-up, both home and laboratory blood pressures were within normotensive range.

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Use of Multiple Visits to Increase Blood Pressure Tracking Correlations in Childhood

PEDIATRICS ◽

10.1542/peds.87.5.708 ◽

1991 ◽

Vol 87 (5) ◽

pp. 708-711

Author(s):

Matthew W. Gillman ◽

Bernard Rosner ◽

Denis A. Evans ◽

Laurel A. Smith ◽

James O. Taylor ◽

...

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Correlation Coefficient ◽

Diastolic Pressure ◽

Pearson Correlation ◽

Systolic Pressure ◽

Pearson Correlation Coefficient ◽

Increase Blood Pressure ◽

Multiple Visit

Previous studies of childhood blood pressure have shown tracking correlations, which estimate the magnitude of association between initial and subsequent measurements, to be lower than corresponding adult values. Inasmuch as this disparity could arise from failing to account for a larger week-to-week variability in children, blood pressure was measured for 4 successive years, on four weekly visits in each year, and with three measurements at each visit, using a random-zero sphygmomanometer, in a cohort of 333 schoolchildren aged 8 through 15 at entry. Ninety percent of subjects had measurements in 1 or more years of follow-up. For all follow-up periods (1, 2, and 3 years from baseline), the Pearson correlation coefficient (r) for both systolic and diastolic blood pressure rose substantially with the number of weekly visits used to calculate each subject's yearly blood pressure (P < .0001). For systolic pressure, the 3-year r values for 1, 2, 3, and 4 visits were .45, .55, .64, and .69, respectively. For diastolic pressure (Korotkoff phase 4), the corresponding values were .28, .41, .47, and .54. These higher multiple-visit estimates of tracking approximate published adult values and raise the possibility that prediction of adult blood pressure from childhood measurements may be improved by averaging readings from multiple weekly visits.

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Usefulness of Exercise Stress Testing for Prediction of Blood Pressure Trends

PEDIATRICS ◽

10.1542/peds.75.6.1071 ◽

1985 ◽

Vol 75 (6) ◽

pp. 1071-1075

Author(s):

David E. Fixler ◽

W. Pennock Laird ◽

Kent Dana

Keyword(s):

Blood Pressure ◽

Stress Testing ◽

Isometric Exercise ◽

Systolic Pressure ◽

Exercise Stress ◽

Female Adolescents ◽

Exercise Stress Testing ◽

Stress Tests ◽

Blood Pressures

The purpose of this study was to determine whether values of blood pressure during exercise help predict which adolescents are prone to maintain high blood pressure. Dynamic and isometric exercise stress tests were performed on 131 adolescents who had had systolic or diastolic pressures greater than the 95th percentile on three examinations the previous year. Follow-up blood pressures were measured 1 year after the stress testing, and outcomes were classified on the basis of the blood pressure status that year. Stepwise regression analysis was used to examine the association between earlier blood pressures and exercise pressures with outcome pressures. In both male and female adolescents, the average resting systolic pressure on the earlier survey was the best predictor of systolic pressure 2 years later. Blood pressures and heart rates during dynamic and isometric exercise did not significantly contribute to the models' prediction of future systolic or diastolic pressures. The data suggest that exercise stress testing is not a valid method for predicting youths whose blood pressures will remain elevated over the next 1 to 2 years.

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Renovascular Hypertension: Comparison of Medical and Surgical Therapy

Clinical Science ◽

10.1042/cs057445s ◽

1979 ◽

Vol 57 (s5) ◽

pp. 445s-447s ◽

Cited By ~ 3

Author(s):

P. K. Whelton ◽

A. P. Harris ◽

R. P. Russell ◽

P. C. Walsh ◽

G. M. Williams ◽

...

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Diastolic Blood Pressure ◽

Renovascular Hypertension ◽

Surgical Therapy ◽

Antihypertensive Medication ◽

Renovascular Disease ◽

Significant Difference ◽

Blood Pressures

1. Results of medical and surgical therapy were compared in 28 patients with hypertension and unilateral renovascular ischaemia. 2. Renal function remained normal in both groups throughout the study period. After 6 months of follow-up systolic and diastolic blood pressures were significantly lower in the surgically treated patients. After 12 months of follow-up there was no significant difference between the two groups in diastolic blood pressure and after 24 months of follow-up there was no significant difference between the two groups in either systolic or diastolic blood pressure. 3. Sixty per cent of surgically treated patients were cured 6 months after operation, but only 40% remained cured after 24 months of follow-up. 4. All patients cured at 6 months who subsequently required antihypertensive medication had arteriosclerotic renovascular disease.

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Familial Aggregation of Blood Pressures of Newborn Infants and Their Mothers

PEDIATRICS ◽

10.1542/peds.58.5.722 ◽

1976 ◽

Vol 58 (5) ◽

pp. 722-729

Author(s):

Yhu-Hsiung Lee ◽

Bernard Rosner ◽

Jeffrey B. Gould ◽

Ernest W. Lowe ◽

Edward H. Kass

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Body Length ◽

Regression Coefficient ◽

Diastolic Pressure ◽

Familial Aggregation ◽

Newborn Infants ◽

Systolic Pressure ◽

Term Infants ◽

Blood Pressures

The blood pressures and pulse rates of 257 normal full-term infants and their mothers were measured two to four days after birth. Birthweight was correlated with systolic (P = .038), but not with diastolic blood pressure. Infants who were asleep had significantly lower systolic and diastolic blood pressure than infants who were awake (P < .001). Sex, body length, and feedings did not appear to influence infant's blood pressure nor did the anesthesia given to the mothers. Maternal diastolic pressure correlated with infant's diastolic pressure (regression coefficient, .128) (P < .01), whereas for systolic pressure the regression coefficient between maternal and infant pressure was .085 (P = NS). The aggregation between the diastolic blood pressures of infants and mothers was not influenced by birthweight, age of the mother, or medication administered to the mother. The pulse rates of black infants were significantly higher than those of white infants (P < .002). There was correlation between the pulse rates and blood pressures in infants.

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The relationship between diastolic blood pressure and the risk of cardiovascular events in patients with atrial fibrillation: the Fushimi AF registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.1168 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Ikeda ◽

M Iguchi ◽

H Ogawa ◽

Y Aono ◽

K Doi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Diastolic Blood Pressure ◽

Cardiovascular Events ◽

Left Ventricular ◽

Cox Proportional Hazards ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

The Impact

Abstract Background Hypertension is one of the major risk factors of cardiovascular events in patients with atrial fibrillation (AF). However, relationship between diastolic blood pressure (DBP) and cardiovascular events in AF patients remains unclear. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Japan. Follow-up data were available in 4,466 patients, and 4,429 patients with available data of DBP were examined. We divided the patients into three groups; G1 (DBP<70 mmHg, n=1,946), G2 (70≤DBP<80, n=1,321) and G3 (80≤DBP, n=1,162), and compared the clinical background and outcomes between groups. Results The proportion of female was grater in G1 group, and the patients in G1 group were older and had higher prevalence of heart failure (HF), diabetes mellitus (DM), chronic kidney disease (CKD). Prescription of beta blockers was higher in G1 group, but that of renin-angiotensin system-inhibitors and calcium channel blocker was comparable. During the median follow-up of 1,589 days, in Kaplan-Meier analysis, the incidence rates of cardiovascular events (composite of cardiac death, ischemic stroke and systemic embolism, major bleeding and HF hospitalization during follow up) were higher in G1 group and G3 group than G2 group (Figure 1). When we divided the patients based on the systolic blood pressure (SBP) at baseline (≥130 mmHg or <130 mmHg), the incidence of rates of cardiovascular events were comparable among groups. Multivariate Cox proportional hazards regression analysis including female gender, age (≥75 years), higher SBP (≥130 mmHg), DM, pre-existing HF, CKD, low left ventricular ejection fraction (<40%) and DBP (G1, G2, G3) revealed that DBP was an independent determinant of cardiovascular events (G1 group vs. G2 group; hazard ratio (HR): 1.40, 95% confidence intervals (CI): 1.19–1.64, G3 group vs. G2 group; HR: 1.23, 95% CI: 1.01–1.49). When we examined the impact of DBP according to 10 mmHg increment, patients with very low DBP (<60 mmHg) (HR: 1.50,95% CI:1.24–1.80) and very high DBP (≥90 mmHg) (HR: 1.51,95% CI:1.15–1.98) had higher incidence of cardiovascular events than patients with DBP of 70–79 mmHg (Figure 2). However, when we examined the impact of SBP according to 20 mmHg increment, SBP at baseline was not associated with the incidence of cardiovascular events (Figure 3). Conclusion In Japanese patients with AF, DBP exhibited J curve association with higher incidence of cardiovascular events. Funding Acknowledgement Type of funding source: None

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Abstract P606: Hemodynamic Predictors of Multiple Recurrent Strokes in the Patients With Prior Lacunar Stroke

Stroke ◽

10.1161/str.52.suppl_1.p606 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Adam H de Havenon ◽

Alexandra Kvernland ◽

Alen Delic ◽

Ka-ho Wong ◽

Nazanin Sheibani ◽

...

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Failure Time ◽

Recurrent Stroke ◽

Cox Proportional Hazards Model ◽

Lacunar Stroke ◽

Blood Pressures ◽

Recurrent Strokes ◽

The Mean

Background: Recurrent stroke has higher morbidity and mortality than incident stroke. We evaluated hemodynamic risk factors for multiple recurrent strokes. Methods: We included patients in the SPS3 trial. The primary predictor was the top tertile, compared to the bottom tertile, of the mean systolic blood pressure (mSBP) and blood pressure variability represented as standard deviation (sdSBP) using blood pressures from day 30 of the trial to the end of follow-up. We excluded blood pressures from the first 30 days to reduce confounding from the trial’s intervention. We fit a logistic regression model to ≥2 recurrent strokes from day 30 to the end of follow-up and, to accurately analyze the multiple failure-time data, we ordered the multiple failure events to the Prentice, Williams and Peterson extension of the Cox proportional-hazards model. Results: We included 2,882 patients, of which 223 had a recurrent stroke and 41/223 had ≥2 recurrent strokes for a total of 272 strokes. The mean (SD) number of blood pressure readings was 78.0 (37.4). The etiology of the 272 strokes was 161 (59.2%) lacunar, 22 (8.1%) intracranial atherosclerosis, 10 (3.7%) extracranial atherosclerosis, 24 (8.8%) cardioembolic, and 55 (20.2%) cryptogenic or other. In both unadjusted and adjusted logistic regression models and PWP Cox models, the top tertile of sdSBP was consistently predictive of multiple recurrent strokes, while mSBP was not (Tables 1/2). Conclusions: We found that in patients with an index lacunar stroke, higher SBP variability, but not mean SBP, was predictive of multiple recurrent strokes of varying mechanisms.

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Serum Zinc Level in Pre-eclamptic Pregnancies: Association with Clinical Complication

Bangladesh Medical Journal ◽

10.3329/bmj.v39i1.6226 ◽

1970 ◽

Vol 39 (1) ◽

pp. 7-10

Author(s):

Touhida Ahsan ◽

Razia Sultana Begum ◽

Sheikh Naznul Islam

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Zinc Concentration ◽

Serum Zinc ◽

Zinc Level ◽

Contributory Factor ◽

Serum Zinc Concentration ◽

Correlative Analysis ◽

Blood Pressures ◽

In Pregnancy

Pre-eclampsia is one of the fatal complications in pregnancy. Zinc plays an important role in the course and eventual outcome of human pregnancy, and is essential for normal embryogenesis and fetal growth. Zinc deficiency in pregnancy is thought to be associated with pre-eclampsia. The aim of this study was, therefore, to investigate the scum zinc level in pre-eclampsia and to examine its association (if any) with pre-eclampsia. A case control study was done among 45 pre-eclamptic and 35 normotensive pregnants at their third trimester. Serum zinc concentration was determined by Atomic Absorption Flame Spectrophotometric method. Correlative analysis was made to find any correlation, of serum zinc with blood Pressure. Results showed identical Maternal and gestational age, and different gravida distribution for the patients and controls, and significantly (P<0.005) higher blood pressures (systolic and diastolic) for pre-eclampsia. Serum zinc concentration were estimated 0.65±0.09mg/L in pre-eclamsia and 0.60±0.08mg/L in pregnant controls, difference of which was insignificant (p=0.284). Correlative analysis wowed that there was a linear correlation between serum level and diastolic blood pressure, but it was found to be insignificant (r=0.158, p=0.330). It was suggested that changes in zinc status may not be an etiological or contributory factor in pre-eclamsia. Key words: Serum zinc; pre-eclampsia; diastolic blood pressure DOI: 10.3329/bmj.v39i1.6226 Bangladesh Medical Journal 2010; 39(1): 7-10

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Comparison of Biofeedback Pulse Wave Velocity and Progressive Relaxation in Essential Hypertensives

Perceptual and Motor Skills ◽

10.2466/pms.1977.44.3.839 ◽

1977 ◽

Vol 44 (3) ◽

pp. 839-843 ◽

Cited By ~ 15

Author(s):

Peter Walsh ◽

Alexander Dale ◽

David E. Anderson

Keyword(s):

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Clinical Effectiveness ◽

Progressive Relaxation ◽

Biofeedback Training ◽

Behavioral Treatments ◽

Blood Pressures ◽

Biofeedback Treatment

In a study undertaken to evaluate the clinical effectiveness of two behavioral treatments for essential hypertension (biofeedback on arterial pulse-wave velocity and progressive relaxation) 24 hypertensive subjects were randomly assigned to either a relaxation or biofeedback treatment group for 5 weekly sessions. In a second stage of the study 16 of the original subjects received both biofeedback and relaxation treatments during 5 additional weekly sessions. Results indicated that biofeedback and relaxation were equally effective in initial lowering of blood pressure in hypertensives. Although biofeedback training led to superior reductions at the 3-mo. follow-up point, after 1 yr. the blood pressures of both groups were not only equal but well below those presented at the beginning of the study.

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Comparison of The Effect of Breads Containing Milled Sesame or Flaxseed on Blood Pressure of Patient in Stage I Hypertension

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v28i10.4925 ◽

2020 ◽

Author(s):

Moneyreh Modarres Mosadegh ◽

Mozhgan Modarresi ◽

Seyedeh Mahdieh Nemayandeh ◽

Masoud Mirzaei ◽

Mahdieh Jabinzadeh ◽

...

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Eating Habits ◽

Systolic Pressure ◽

Physical Activities ◽

Abdominal Circumference ◽

Type I ◽

Demographic Information ◽

Significant Difference ◽

Single Blind

Introduction: Flaxseed and sesame both are capable of reducing blood pressure, but no studies have been done to compare their effects on hypertension. The purpose of this study was to compare the effect of breads containing either milled sesame or flaxseed on blood pressure of patients with type I hypertension. Methods: This was a randomized, single blind clinical trial study. Demographic information was obtained from 100 eligible patients and they were randomly allocated to flaxseed or sesame groups. They received breads containing 30 g of either flaxseed or sesame for 14 weeks. Blood pressure, abdominal circumference, and BMI (body mass index) were measured at the beginning, seventh week, and at the end of study. Questionnaires regarding their eating habits and physical activities were also completed at these times. Data was analyzes by SPSS version 16 and independent sample t test and repeated measurement test. Results: Both sesame and flaxseed significantly reduced systolic and diastolic blood pressure (p=0.001) and there was no significant difference. On average, systolic pressure decreased by 9.5 mmHg with sesame and 10 mmHg with flaxseed. Likewise, diastolic blood pressure decreased by 5.05 mmHg with sesame and 5.8 mmHg with flaxseed. BMI and abdominal circumference reduced in both flaxseed (p= 0.001 and 0.001, respectively) and sesame (p=0.01 and 0.02, in order). No difference was observed between these groups. Conclusion: Both sesame and flaxseed could similarly decrease systolic and diastolic blood pressure, abdominal circumference, and BMI. Therefore, they could be used as supplements in reducing blood pressure.

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Evaluation of blood pressure in school children aged 12-16 years

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172607 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1218

Author(s):

Balakrishnan Nadesan ◽

Mani Madhavan Sachithananthamoorthi ◽

Sivaraman Thirumalaikumarasamy ◽

Ezhilarasu Ramalingam

Keyword(s):

Blood Pressure ◽

Family History ◽

Diastolic Blood Pressure ◽

School Children ◽

Diastolic Pressure ◽

Systolic Pressure ◽

Cross Sectional ◽

Significant Difference ◽

History Of ◽

Family History Of Hypertension

Background: Hypertension is considered as a major health issue in developed as well as developing countries and its possible origin during childhood prompts pediatricians to routinely include measurement of blood pressure (BP) as an integral part of pediatric physical examination. The objectives of the study were to evaluate the normal range of blood pressure in adolescent school going students of 12-16 years, prevalence of hypertension and relationship of BP with variables like age, body mass index (BMI), socioeconomic status and family history of hypertension.Methods: A cross sectional study was undertaken for a period of one year in adolescent school children in age groups between 12-16 years. Detailed clinical examination was done in 1060 adolescent school children and BP was recorded in right upper limb and correlation of BP with BMI, family history of hypertension and diabetes were studied.Results: Mean systolic and diastolic pressure showed linear relationship with age. There was a highly statistically significant difference between mean systolic and diastolic blood pressure between lower and middle socio-economic class. Prevalence of obesity in our study was 1.13%, overweight was 7.83%. Prevalence of hypertension in obese children was 33.33% and in overweight children 18.07%. Family history of hypertension and diabetes carry a significant correlation with elevated systolic and diastolic blood pressure in adolescents.Conclusions: This study revealed that socio economic factors play a significant role in determining the blood pressure of the individual. Children of middle class have significantly elevated mean systolic pressure and mean diastolic pressure than low socio-economic groups.

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