scholarly journals Effects of different ablation points of renal denervation on the efficacy of resistant hypertension

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9842
Author(s):  
Hua Zhang ◽  
Ling-Yan Li ◽  
Rong-Xue Xiao ◽  
Ting-Chuan Zhang ◽  
Zong-Jun Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Standard Treatment ◽  
Intensive Treatment Group ◽  
The Mean ◽  
Standard Treatment Group

Objective To explore the blood pressure response to different ablation points of renal denervation (RDN) in patients with resistant hypertension Methods A total of 42 cases with resistant hypertension treated by RDN in our center from 2013 to 2015 were retrospectively analyzed. The patients were divided into two groups according to the different ablation points of RDN: the standard treatment group (spiral ablation from near to proximal, with less than 8 points per artery) and the intensive treatment group (from near to far by spiral ablation, with at least 8 points per artery), with 21 patients in each group. The ablation parameters, including points, impedance, actual wattage, and actual temperature, were recorded intraoperatively. Renal angiography was performed again after RDN. Ambulatory blood pressure (ABP) images were taken for all patients at the baseline and 6 months after operation. Results The mean 24-h blood pressure of the standard treatment group was lower than that of the baseline (24-h systolic blood pressure decreased by 7.4 ± 10.6 mmHg and 24-h diastolic blood pressure decreased by 4.6  ± 6.1 mmHg), and the mean 24-h blood pressure decreased significantly from baseline to 6 months in the intensive treatment group (24–h systolic blood pressure decreased by 27.4 ±  11.4 mmHg, P < 0.0001; 24–h diastolic blood pressure decreased by 10.9 ±  9.6 mmHg, P = 0.005). There was a positive correlation between the decrease of systolic/diastolic 24-hour mean and the number of ablation points used in the procedure. The mean value of systolic and diastolic blood pressure was positively correlated with ablation points at 24-hour (R2 = 0.777 and 0.633 respectively, P < 0.01). There were no adverse events in either group after the operation and during the follow-up. Conclusions RDN could significantly reduce BP in patients with resistant hypertension. Our study showed that the antihypertensive effect appeared to be positively correlated with the number of ablation points.

scholarly journals Impact of renal denervation on 24-hour blood pressure pattern in patients with resistant hypertension

2019 ◽  
Vol 4 (4) ◽  
pp. 78-88 ◽  
Author(s):  
T. Yu. Chichkova ◽  
S. E. Mamchur ◽  
M. P. Romanova ◽  
E. A. Khomenko
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistant Hypertension ◽  
Blood Pressure Variability ◽  
Renal Denervation ◽  
Pressure Pattern

Aim. To estimate the dynamics of 24-hour blood pressure pattern in patients with resistant hypertension after renal denervation in comparison with the conservative treatment group.Methods. We enrolled 45 patients (21 men and 24 women, mean age 53 (43-66) years) with resistant hypertension. Renal denervation was performed in 25 patients using Vessix renal denervation system while the conservative treatment group included 20 patients. Monitoring of 24-hour blood pressure pattern was performed before renal denervation and after 1 year of follow-up.Results. Twelve months after renal denervation, patients with resistant hypertension had a significant reduction in office blood pressure (33 and 15 mmHg for systolic and diastolic blood pressure, respectively) and 24-hour average blood pressure (29 and 12 mmHg, for systolic and diastolic blood pressure, respectively). Another beneficial effect of renal denervation was a decrease in systolic blood pressure variability both throughout the day and at night (6 (5-12) and 7 (7-10) mmHg, respectively); however, no changes in diastolic blood pressure variability have been registered. Despite renal denervation did not affect the morning blood pressure surge, morning systolic blood pressure reduced from 174 (130180) mmHg to 156 (130-165) mmHg. After 1 year of follow-up, the proportion of dippers increased from 16 to 44%. In contrast to the patients who underwent renal denervation, there were no significant changes in 24-hour blood pressure pattern in the conservative treatment group.Conclusion. After 1 year of follow-up, renal denervation can be considered as an option superior to conservative treatment in patients with resistant hypertension, as it significantly improved 24-hour blood pressure pattern.

Abstract 113: Beneficial or Harmful? The Role of Intensive Anti-hypertensive Treatment in the Development of Chronic Kidney Disease

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Ling Wang ◽  
Donna Wang
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Systolic Blood Pressure ◽  
Standard Treatment ◽  
Intensive Treatment ◽  
Percent Reduction ◽  
Data Set ◽  
Treatment Target ◽  
Renal Outcomes ◽  
Standard Treatment Group

Hypertension is the leading cause of end-stage renal disease, and one of the goals of anti-hypertensive treatment is to protect the kidney. However, it is unknown how low of blood pressure as the treatment target should be so that anti-hypertensive therapy would not bring harm to patients especially for those already suffer from chronic kidney disease (CKD). Thus, we used the data set from The Systolic Blood Pressure Intervention Trial (SPRINT) to study the effect of lowering systolic blood pressure on renal disease development. The SPRINT data randomly assigned patients with a systolic blood pressure (SBP) of 130 mm Hg or higher to a SBP treatment target of less than 120 mm Hg (intensive treatment, n=4678) or a treatment target of less than 140 mm Hg (standard treatment, n=4683). We examined the effect of intensive treatment on six renal outcomes: 1) CKD composite, 2)50 percent reduction in eGFR, 3) dialysis 4) albuminuria, 5) 30 percent reduction in eGFR for patients with CKD at baseline (n=2646) and 6) albuminuria for patients without CKD at baseline (n=6715). Generalized Estimating Equation is used to account the correlation of blood pressure levels over time. At the end of year 1, the mean SBP was 121.4± 0.21 mm Hg in the intensive treatment group and 136.2± 0.21 mm Hg in the standard treatment group. The patients in intensive group were found to have a higher chance of 30% reduction of eGFR (OR=3.684, 95% CI= 2.51-5.40) than in standard treatment group. There was no difference between intensive and standard treatment groups for other 5 outcomes. In addition, 1 mm Hg elevation in SBP in patients with CDK at baseline significantly increased the chance of CKD composite (OR=1.03, 95% CI=1.01-1.04), the chance of 50 percent reduction in eGFR (OR=1.02, 95% CI=1.01-1.05), and chance of 30 percent reduction in eGFR (OR=1.02, 95% CI=1.01-1.02). Thus, SBP significantly correlated with renal outcomes in CKD patients. Our data show that five renal outcomes examined using SPRINT data set are not improved by intensive management of SBP in CKD patients, rather, patients received intensive management have a higher risk of eGFR reduction by 30%, which could be detrimental. Our study indicated that intensive SBP management should not be recommended to CKD patients.

RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Correlation ◽  
Mean Value ◽  
The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

scholarly journals The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (13) ◽  
pp. 2824
Author(s):  
Su-Kiat Chua ◽  
Wei-Ting Lai ◽  
Lung-Ching Chen ◽  
Huei-Fong Hung
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Publication Bias ◽  
Meta Analysis ◽  
Systemic Review ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Mean

Background: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relevant published articles from PubMed, Cochrane base, and Medline were examined, and the last search date was December 2020. Only published randomized controlled trials and double-blind studies were selected for further analysis. The mean reductions in systolic blood pressure (msSBP) and diastolic blood pressure (msDBP) in the sitting position, as well as the mean reductions in ambulatory systolic blood pressure (maSBP) and ambulatory diastolic blood pressure (maDBP), were assumed as efficacy endpoints. Adverse events (AEs) were considered as safety outcomes. Results: Ten studies with a total of 5931patients were included for analysis. Compared with placebo, LCZ696 had a significant reduction in msSBP (weight mean difference (WMD) = −6.52 mmHg, 95% confidence interval (CI): −8.57 to −4.47; p < 0.001), msDBP (WMD = −3.32 mmHg, 95% CI: −4.57 to −2.07; p < 0.001), maSBP (WMD = −7.08 mmHg, 95% CI: −10.48 to −3.68; p < 0.001), maDBP (WMD = −3.28 mmHg, 95% CI: −4.55 to −2.02, p < 0.001). In subgroup analysis, only 200 mg and 400 mg LCZ696 showed a significant BP reduction. There was no difference in the AE rate between the LCZ696 and placebo groups (WMD = 1.02, 95% CI: 0.83 to 1.27, p = 0.54). Egger’s test revealed a potential publication bias for msSBP (p = 0.025), but no publication bias for other outcomes. Conclusion: LCZ696 may reduce blood pressure more efficaciously than traditional therapy in hypertensive patients without increasing adverse effects.

THE BLOOD PRESSURE OF NEWBORN INFANTS: INDIRECT DETERMINATION BY AN AUTOMATIC BLOOD PRESSURE RECORDER IN 20 INFANTS

PEDIATRICS ◽  
1960 ◽  
Vol 25 (1) ◽  
pp. 50-53
Author(s):  
Robert L. Morse ◽  
Gordon L. Brownell ◽  
James H. Currens
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Newborn Infants ◽  
Indirect Determination ◽  
Pressure Recording ◽  
Automatic Blood Pressure ◽  
Blood Pressures ◽  
The Mean ◽  
Blood Pressure Recording

Systolic and diastolic blood pressures have been determined in 20 infants by the use of an automatic blood pressure-recording machine. The mean systolic blood pressure was 7.1 cm Hg (range 5.8 to 9.5). The mean diastolic blood pressure was 5.2 cm Hg (range 4.2 to 6.4).

scholarly journals Pattern of Blood Pressure Distribution among University Students in Ajman, United Arab Emirates

2011 ◽  
Vol 1 (3) ◽  
pp. 86-89
Author(s):  
S A Basha ◽  
E Mathew ◽  
Jayadevan Sreedharan ◽  
Jayakumari Muttappallymyalil ◽  
S A Sharbatti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
University Students ◽  
Systolic Blood Pressure ◽  
Pressure Distribution ◽  
Diastolic Blood Pressure ◽  
United Arab Emirates ◽  
Allied Health ◽  
Health Science ◽  
P Value ◽  
The Mean

Background Elevated blood pressure has been identified as a silent killer contributing to mortality and morbidity worldwide, hence it is essential to identify the high risk individuals at an early age to prevent the progress of the disease and its co-morbid conditions. Objective The objective of the present cross-sectional study was to assess the pattern of blood pressure distribution among students of medical and allied health professions at Gulf Medical University (GMU) Ajman, United Arab Emirates (UAE). Methods The study was conducted from November 2009 to February 2010. GMU has academic programmes such as Bachelor of Medicine, Physical therapy, Pharm D and Dental Medicine with a multiethnic student population. A pretested structured instrument used for data collection and blood pressure was measured using mercury sphygmomanometer. Descriptive statistics such as means and standard deviation were used to summarize the quantitative variables. The association of age, gender and nationality with systolic and diastolic blood pressure was determined by Pearson's correlation coefficient and a p-value ≤ 0.05 was considered statistically significant. Results The systolic and diastolic blood pressures were evenly distributed across all students irrespective of their age. A significantly higher systolic blood pressure in males was observed when compared to females, but the difference was not significant in diastolic blood pressure. In the present study among medical and allied health science students, the distribution of blood pressure was not associated with age. The mean systolic blood pressure and diastolic blood pressure were seen to be higher among Arabs when compared to Non-Arabs though not statistically significant. Family history of metabolic diseases did not show any association with the mean blood pressure. Conclusion There was a strong association for developing hypertension among male when compared to female gender. Key Words: University students; Age; Gender; Nationality; Systolic blood pressure; Diastolic blood pressureDOI: http://dx.doi.org/10.3126/nje.v1i3.5572 Nepal Journal of Epidemiology 2011;1(3) 86-89

scholarly journals Blood Pressure Association with Sodium Intake from Snacks Among Undergraduates of Afe Babalola University, Nigeria

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 152-152
Author(s):  
Kayode Ajayi ◽  
Ibidayo Alebiosu
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
Odds Ratio ◽  
Sodium Intake ◽  
Metabolic Equivalent ◽  
The Mean

Abstract Objectives The aim of the study was to assess the association between blood pressure (BP) values and sodium intake from snacks. Methods The mean weekly consumption of snacks was evaluated in 1500 randomly selected undergraduate aged 16–24 years by a food frequency questionnaire. Participants were divided into quartiles of systolic blood pressure and diastolic blood pressure. The mean weekly exercise level was calculated as the product of duration and frequency of each activity (in hours/week), weighted by an estimate of the metabolic equivalent of the activity (MET) and summed for the activities performed. The whole cohort was divided into tertiles of exercise and the individuals were classified as; sedentary, moderately active and active. The cut of points in the whole cohort were respectively; ≤10, 11–29, ≥30 MET h/week. Exercise levels were therefore expressed as MET h/week. Results The mean age, metabolic equivalent of activity (METs), body mass index (BMI) and mean sodium intake from snacks per day were; 20.10 ± 1.44 years, 25.51 ± 10.03 METs h/week, 24.86 ± 4.80 kg/m2 and 1.5 g/day respectively. Systolic blood pressure (SBP) ranges between 104.43 ± 4.89 mmHg and 137.27 ± 16.71 mmHg while the diastolic blood pressure (DBP) ranges from 71.24 ± 7.83–83.11 ± 12.03 mmHg. The SBP and DBP significantly increased from the lower to the higher tertile of sodium from snacks and with increasing frequency of salty snacks consumption (P &lt; 0.001). In the multiple logistic regression model, being in the highest SBP quartile (≥115 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 1.46; 95% confidence interval (CI) 1.13–1.82; P = 0.001), age, gender and body mass index. Also, being in the highest DBP quartile (≥70 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 2.84; 95% confidence interval (CI) 1.41–5.69; P = 0.003), age, body mass index, but not with gender. Conclusions The study has shown that a strong association exists between sodium intake from snack, daily frequency of consumption of salty snacks and blood pressure. Public education and social marketing are needed to motivate the undergraduate to choose healthier snacks with lower sodium content. Funding Sources The study did not receive any funding from any source.

THE PREDICTIVE VALUE OF MODIFIED SHOCK INDEX FOR HOSPITAL MORTALITY

2021 ◽  
pp. 19-21
Author(s):  
Praveenkumar Biradar ◽  
Vijayakumara Vijayakumara ◽  
Veeresh B ◽  
Udaykumar Jaihind Khasage ◽  
Kartik Katti
Keyword(s):  
Blood Pressure ◽  
Hospital Mortality ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Clinical Severity ◽  
Age Group ◽  
Shock Index ◽  
Inclusion Criteria ◽  
The Mean ◽  
Lactate Levels

INTRODUCTION: Shock Index uses only systolic blood pressure; however, diastolic blood pressure is also of undeniable importance when determining patient's clinical severity. All METHODOLOGY: patients who t into the inclusion criteria were requested for consent to join the study. The patients were further divided into sub-groups as per their working diagnosis as medical or surgical cases and denitive diagnosis were noted. In the prese RESULTS: nt study, the mean age group for patients on whom lactate levels were done was found to be 53.2±15.9 years and the maximum study samples were in the age group 60-69. The mean of systolic blood pressure, diastolic blood pressure, heart rate, MAP, Shock Index, Modied Shock Index and lactate levels in our study was 104.1±26.8 mm/hg, 72.4±18.4 mm/hg, 116.9±18.7, 83.1±20.4 mm/hg, 1.2±0.5, 1.5±0.6 and 4.9±2.6 respectively. The p CONCLUSION: redictive value of MSI for hospital mortality was calculated by ROC curve where the sensitivity was 0.750 and specicity was 0.454.

scholarly journals Effect of Steroid during Perioperative Period in Patients with Patent Ductus Arteriosus (PDA) Ligation

2017 ◽  
Vol 5 (1-2) ◽  
pp. 9-14
Author(s):  
Kazi Zahidul Hoque ◽  
Masumul Gani Chowdhury ◽  
Mamun Miah ◽  
Akhand Tanzih Sultana
Keyword(s):  
Treatment Group ◽  
Preterm Infants ◽  
Standard Treatment ◽  
Ductus Arteriosus ◽  
Mean Airway Pressure ◽  
Surgical Ligation ◽  
Pda Ligation ◽  
The Mean ◽  
Standard Treatment Group ◽  
Stress Dose

Background & Objective: Patent ductus arteriosus (PDA) is a common condition in preterm infants and is associated with profound morbidity and mortality. Pharmacotherapy (indomethacin or ibuprofen) is the first choice to close the PDA, but if pharmacological closure is contraindicated or failed, surgical ligation is usually performed. But following surgical ligation of PDA, preterm infants may develop severe hypotension and respiratory failure. Prophylactic stress hydrocortisone (HC) has emerged as a therapy to prevent complications, although its efficacy in reducing postoperative hypotension and oxygenation difficulties has not been rigorously tested. The purpose of this study was to compare the outcomes in preterm infants who received stress HC before their PDA ligation to those who did not (standard treatment group or control). Materials & Methods: This comparative clinical trial was conducted in Dhaka Shishu Hospital (DSH), Dhaka over a period of 15 months between April 2014 to June 2015. A total of 40 infants with a significant PDA and a history of failed medical treatment were included in the study and were divided into two groups (each group having 20 infants) – one receiving stress HC before PDA ligation (Case) and the other did not (Control). Respiratory support, expressed as highest FiO2, highest mean airway pressure and mode of ventilation, was noted as was cardiovascular support including inotropic medication, its dose throughout the preoperative and the postoperative periods. Post-operative cardiovascular and respiratory supports were the main outcome measures which were measured within 72 hours following PDA ligation. Result: At baseline both the study groups were almost similar with respect to their sex, gestational age, birth weight, and age at surgery and prenatal steroid exposure. However, there was more incidence of preoperative steroid exposure in standard treatment group. Urine output was somewhat higher in the standard treatment group compared to the HC group but it was not statistically significant (1.33 vs. 1.21 ml/kg/min, p = 0.205). The mean arterial pressure was higher in the HC group than that in the standard treatment group (92.5 vs. 86.7 mmHg, p = 0.018), but it was clinically insignificant. The study observed that infants who received stress dose HC rarely needed vasopressor support post ligation and their average and highest doses of dopamine were also significantly lower compared to their standard treatment group. The postoperative high-frequency ventilation was more often needed in the standard treatment group, although none in either group needed this support preoperatively. The mean airway pressure was although similar in both groups the highest FiO2 was much less in the HC group. Conclusion: The study concluded that stress dose HC given to preterm infants before surgical ligation of PDA may improve the postoperative cardiorespiratory outcomes. But as the sample size was too small, this finding requires validation by large-scale study. Ibrahim Card Med J 2015; 5 (1&2): 9-14

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