Pengaruh Senam Aerobik Low Impact Terhadap Tekanan Darah Pada Lansia dengan Hipertensi : Literature Review

Hypertension is the most common degenerative disease suffered by the elderly. It caused by variuos factors, such as age, history of hypertension, high sodium consumption and lack of physical activity. Exercise suc as low impact aerobic can reduce heart rate related to decrease in cardiac output. Consequently, blood pressure will decrease gradually. The purpose of the study was to describe the effect of low impact aerobic exercise on blood pressure in elderly with hypertension. The study used a literature review, by accessing the Garuda and ProQuest database using the keyword “Hypertension” AND “Elderly” AND “Low Impact Aerobic Exercise” AND “Blood Pressure”. The result show that there is an effect of low impact aerobic exercise on blood pressure in the elderly with hypertension. After the interventions, the systolic and dyastolic blood pressure was decrease 10.16 mmHg ang 5,02 mmHg, respectively. Low impact aerobic exercise is effective in decrease blood pressure in elderly with hypertension. Low impact aerobic exercise can be an alternative to overcome the problem of hypertension among elderly in family, community and gerontology nursing settings.Keywords: Blood Pressure, elderly, Hypertension, low Impact Aerobics AbstrakHipertensi merupakan penyakit degeneratif yang paling bnayak diderita oleh lansia. Hal ini disebabkan oleh berbagai faktor, seperti usia, riwayat penyakit hipertensi, konsumsi tinggi garam dan kurangnya aktivitas fisik. Latihan fisik seperti senam aerobik low impact dapat menurunkan denyut jantung dimana terjadi penurunan pada cardiac output yang akhirnya dapat menurunkan tekanan darah. Tujuan dari penelitian ini yaitu untuk mendeskripsikan pengaruh senam aerobik low impact terhadap tekanan darah pada lansia dalam literature review. Metode yang digunakan dalam penelitian ini adalah literature review, dengan mengakses database Portal Garuda dan Proquest dengan menggunakan kata kunci “Hipertensi” DAN ”Lansia” DAN ”Senam Aerobik Low Impact” DAN ”Tekanan Darah”. Hasil penelitian ini menunjukkan bahwa terdapat pengaruh senam aerobik low impact terhadap tekanan darah pada lansia dengan hipertensi yang ditandai dengan adanya penurunan nilai sistole dan diastole setelah diberikan intervensi senam aerobik low impact. Hasil penelitian ini diketahui terdapat pengaruh senam aerobik low impact terhadap tekanan darah pada lansia dengan hipertensi, diharapkan dapat menjadi referensi di keperawatan keluarga maupun komunitas pada lansia untuk meningkatkan aktivitas senam aerobik low impact dalam mengatasi masalah hipertensi pada lansia.Kata kunci : Hipertensi, Lansia, Senam Aerobik Low Impact, Tekanan Darah

Breathing exercises for the treatment of anxiety symptoms

Breathing exercises have been used successfully to reduce the negative symptoms characterised anxiety and depression. One of the most effective methods of psychological counseling with students and other persons included in education sphere is breathing relaxation exercises, which can improve concentration, reduce anxiety, reduce heart rate, reduce muscle tension and improve sleep quality. The article presents the anatomical side of breathing exercises, physiological mechanisms and specific instructions for the practical use of the method.

Timely and individualized heart failure management: need for implementation into the new guidelines

Due to remarkable improvements in heart failure (HF) management over the last 30 years, a significant reduction in mortality and hospitalization rates in HF patients with reduced ejection fraction (HFrEF) has been observed. Currently, the optimization of guideline-directed chronic HF therapy remains the mainstay to further improve outcomes for patients with HFrEF to reduce mortality and HF hospitalization. This includes established device therapies, such as implantable defibrillators and cardiac resynchronization therapies, which improved patients' symptoms and prognosis. Over the last 10 years, new HF drugs have merged targeting various pathways, such as those that simultaneously suppress the renin–angiotensin–aldosterone system and the breakdown of endogenous natriuretic peptides (e.g., sacubitril/valsartan), and those that inhibit the If channel and, thus, reduce heart rate (e.g., ivabradine). Furthermore, the treatment of patient comorbidities (e.g., iron deficiency) has shown to improve functional capacity and to reduce hospitalization rates, when added to standard therapy. More recently, other potential treatment mechanisms have been explored, such as the sodium/glucose co-transporter inhibitors, the guanylate cyclase stimulators and the cardiac myosin activators. In this review, we summarize the novel developments in HFrEF pharmacological and device therapy and discuss their implementation strategies into practice to further improve outcomes.

Ivabradine-Stimulated Microvesicle Release Induces Cardiac Protection against Acute Myocardial Infarction

Ivabradine can reduce heart rate through inhibition of the current I(f) by still unexplored mechanisms. In a porcine model of ischemia reperfusion (IR), we found that treatment with 0.3 mg/kg Ivabradine increased plasma release of microvesicles (MVs) over Placebo, as detected by flow cytometry of plasma isolated from pigs 7 days after IR, in which a tenfold increase of Extracellular Matrix Metalloproteinase Inducer (EMMPRIN) containing (both high and low-glycosylated) MVs, was detected in response to Ivabradine. The source of MVs was investigated, finding a 37% decrease of CD31+ endothelial cell derived MVs, while CD41+ platelet MVs remained unchanged. By contrast, Ivabradine induced the release of HCN4+ (mostly cardiac) MVs. While no differences respect to EMMPRIN as a cargo component were found in endothelial and platelet derived MVs, Ivabradine induced a significant release of EMMPRIN+/HCN4+ MVs by day 7 after IR. To test the role of EMMPRIN+ cardiac MVs (EMCMV), H9c2 cell monolayers were incubated for 24 h with 107 EMCMVs, reducing apoptosis, and increasing 2 times cell proliferation and 1.5 times cell migration. The in vivo contribution of Ivabradine-induced plasma MVs was also tested, in which 108 MVs isolated from the plasma of pigs treated with Ivabradine or Placebo 7 days after IR, were injected in pigs under IR, finding a significant cardiac protection by increasing left ventricle ejection fraction and a significant reduction of the necrotic area. In conclusion ivabradine induces cardiac protection by increasing at least the release of EMMPRIN containing cardiac microvesicles.

IMPACT OF CARDIOGEN INJECTION IN THE ADRENALINE-INDUCED STRESS MODEL ON THE RATE OF THE HEART INDEX AND WEIGHTED PARAMETERS OF RAT BODIES

The article presents the results of a study of the effect of Cardiogen on changes in heart rate and weight parameters of organs under stress in rats. The introduction of Cardiogen compensates for the stressful effect of adrenaline on the change in the relative mass of the heart, adrenal glands and spleen. Cardiogen also helps reduce heart rate to control values and manifestations of arrhythmia under stress.

Symptomatic myocardial bridging: a frequently occurring coronary variation can cause severe myocardial ischaemia in affected children with underlying cardiac conditions

Myocardial bridging is a congenital coronary artery anomaly in which the coronary artery has a partly “tunnelled” intramyocardial course. This tunnelling leads to compression of the affected vessel segment during ventricular systole. It is considered to be a benign variation of the norm in about 25% of the population caused by an aberrancy of embryologic coronary development. The bridging is also thought to cause severe cardiac conditions in a few of those affected. The series of six young patients presented here is the largest series so far to report on symptomatic myocardial bridging in children with different underlying heart diseases. All patients recently presented to our centre with signs of myocardial ischaemia. They subsequently underwent coronary angiography, which revealed myocardial bridging of the ramus interventricularis anterior. In all patients, therapy with β blockers was started to reduce heart rate and myocardial contractility. β Blocker treatment was also given in order to prolong diastole and improve coronary artery blood flow. Two patients underwent surgical exposure of the involved coronary segment: a 2-year-old boy because of recurrent, severe myocardial ischaemia in combination with a reduction of general health, changes in ST-segments, and the presence of a dilative cardiomyopathy; and a 13-year-old girl because of evidence of myocardial ischaemia during exercise testing after surviving sudden cardiac death. Surgery was successful and recovery was complete and uneventful. The presented series shows that myocardial bridging can be symptomatic and may require urgent treatment and even surgical intervention in early childhood in rare cases.

Optimization of the process parameters in rice mill using Response surface methodology (RSM)

Objective of the current study was to analyze a wooden plank used as a loading ramp to perform manual handling task with a view to redesign and develop the new one for agriculture. Developed ramp was more wide, static and non slippery than the wooden plank. For this purpose experiments were conducted on a group of 10 experienced manual handlers in the KLA rice mill of Rudrapur Block, district Udhamsingh Nagar, Uttarakhand, India. The reliability and validity of the developed, modern loading ramp was assessed by using response surface methodology in terms of change in MSD, heart rate and VO2 max. Therefore RSM was applied to optimize the operating parameters of ramp such as load weight, height of ramp and time. As per Box Behenken design total 17 experiments were carried out. Each parameter was varied over three levels as load weight of 40, 50 and 60 kg., height of ramp 3, 4 and 5 feet, and the time viz. 3, 4 and 5 min. ANOVA test and coefficient of determination (R2) were applied. In result it was observed that use of developed pant loading ramp was able to reduce heart rate of selected respondent’s from 135.4 beats/min. to 126.76 beats/min., MSD from 85.45 to 22.80 % and VO2 max from 39.45 to 34L/min.

Femoral and sciatic nerve blockades and incision site infiltration in rabbits undergoing stifle joint arthrotomy

This study was designed to determine whether perineural injections of local anaesthetics decreases intraoperative nociception and improves postoperative analgesia in New Zealand White rabbits undergoing experimental stifle arthrotomy. All animals were anaesthetized using isoflurane and received morphine intramuscularly. The sciatic and femoral nerves of the leg to be operated on were located using a nerve stimulator (1 Hz, 0.5 mA). Rabbits were assigned to a treatment group (LB; n = 12) or a placebo group (P; n = 12) in a randomized blinded fashion. Group LB received lidocaine 2% (1 mg/kg) combined with bupivacaine 0.5% (0.25 mg/kg) injections around the sciatic and femoral nerves (0.1 mL/kg total volume per site) and subcutaneous infiltration of the incision site with lidocaine 1% (1.25 mg/kg). Group P received the same volume of 0.9% NaCl. Rabbits in group P required higher doses of intraoperative fentanyl and propofol to reduce heart rate and suppress increase in systolic blood pressure, and maintain an adequate anaesthetic plane. Interventional analgesia (buprenorphine and carprofen) was required significantly earlier in rabbits in group P (2 and 6 h after the first nerve blockade, respectively) based on assessment of their pain-related behaviour and range of motion. Using a visual analogue scale (0 mm= no pain to 100 mm= maximal possible pain), rabbits in group LB were judged to show significantly less pain compared with rabbits in group P (14 ± 10 mm and 37 ± 25 mm, respectively) 2 h after nerve blockade. In conclusion, this technique of perineural analgesia combined with incision site infiltration reduced intraoperative fentanyl requirements and improved postoperative analgesia in rabbits.