Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis

Background. Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension. Methods. Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed. Results. It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = −5.94, 95% CI: −8.57, −3.30; diastolic blood pressure (DBP): WMD = −2.66, 95% CI: −3.66, −1.67), yoga (SBP: WMD = −5.09, 95% CI: −9.28, −0.89; DBP: WMD = −3.06, 95% CI: −5.16, −0.96), aquatic sports (SBP WMD = −7.53, 95% CI: −11.40, −3.65; DBP: WMD = −5.35, 95% CI: −9.00, −1.69), and football (SBP: WMD = −6.06, 95% CI: −9.30, −2.82; DBP: WMD = −5.55, 95% CI: −8.98, −2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = −8.31, 95% CI: −20.39, 3.77; DBP: WMD = −3.05, 95% CI: −6.96, 0.87) and Qigong (SBP: WMD = −4.34, 95% CI: −13.5, 4.82; DBP: WMD = −3.44, 95% CI: −7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high. Conclusion. Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.

The Effectiveness of Cultural Deep Breathing against Blood Pressure Reduction

Elderly is a process of disappearing in the ability of tissues to repair themselves or replace themselves and maintain their normal structure and function. This study aims to find out the effectiveness of deep breathing against decreased blood pressure in the elderly who have hypertension. The study used the one group pre-post test. The sample used as many as 13 participants. The study used Purposive Sampling techniques and the tool used to obtain the data. The study used a paired sample t-test with a significance value of α=0.05. The results of this study showed that there was an effect of deep breathing on the decrease in blood pressure in the elderly who had hypertension on the first day and the third day with a value of p= 0.000<α = 0.05. There is an effect of giving deep breathing to decrease blood pressure in elderly people who have hypertension on the 4th day and the sixth day with a value of p= 0.000<α = 0.05. There is an effect of giving deep breathing to the decrease in blood pressure in the elderly who have hypertension.

Greater Reduction of Blood Pressure with Exercise Intervention Than Standard Care After Recent Ischaemic Atroke: A Randomized Clinical Trial

Context and Objectives: Ischaemic stroke (IS) causes disability and uses massive public health resources. Cumulative disability from recurrence may be reduced with cardiometabolic risk reduction strategies e.g., lowering blood pressure (BP). We hypothesized that intensive exercise plus best available care in adults with recent IS improves fitness, glucose metabolism, muscle protein synthesis in paretic limbs compared to controls. BP changes were compared between intervention (INT) and controls (CON). Research Design and Setting: A randomised, interventional clinical trial conducted in Jamaican adults subjects: We investigate 103 adults with recent IS and residual weakness. Forty-nine subjects (24 women: mean age 61.5; 25 men: mean age 63.8) received task-oriented exercise training (TEXT) plus best available care. Fifty-four subjects (23 women: mean age 60.2; 31 men: mean age 61.3) received best care, including exercise advice. Measurements: We measured baseline, 3-month and 6-month BP. Results: After recent IS, TEXT plus best available care reduced systolic BP by 21 mmHg and diastolic by 12 mmHg compared to controls, independent of medication adherence, body composition; stroke severity. Men in the TEXT group had increased lean mass (P < 0.007), VO2 max (P = 0.03); 6-minute walk distance (P = 0.003). Leg press on paretic (P = 0.004) and non-paretic (P < 0.001) increased with TEXT vs CON over 6 months, in both sexes (P-values for sex difference > 0.2). Time-to-chair-rise decreased in both sexes who received intervention vs controls (P <0.04) Conclusions: TEXT results in significant blood pressure reduction in adults with recent ischaemic stroke and residual weakness when compared with best available medical care only.

J-shape relation of blood pressure reduction and outcome in acute intracerebral hemorrhage: A pooled analysis of INTERACT2 and ATACH-II individual participant data

Objective: The aim of this study was to better define the shape of association between the degree (“magnitude”) of early (< 1 h) reduction in systolic blood pressure (SBP) and outcomes in patients with acute intracerebral hemorrhage (ICH) through pooled analysis of the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) and second Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-II) datasets. Methods: Association of the continuous magnitude of SBP reduction described using cubic splines and an ordinal measure of the functional outcome on the modified Rankin scale (mRS) scores at 90 days were analyzed in generalized linear mixed models. Models were adjusted for achieved (mean) and variability (standard deviation, SD) of SBP between 1 and 24 h, various baseline covariates, and trial as a random effect. Results: Among 3796 patients (mean age 63.1 (SD = 13.0) years; female 37.4%), with a mean magnitude (< 1 h) of SBP reduction of 28.5 (22.8) mmHg, those with larger magnitude were more often non-Asian and female, had higher baseline SBP, received multiple blood pressure (BP) lowering agents, and achieved lower SBP levels in 1–24 h. Compared to those patients with no SBP reduction within 1 h (reference), the adjusted odds of unfavorable functional outcome, according to a shift in mRS scores, were lower for SBP reductions up to 60 mmHg with an inflection point between 32 and 46 mmHg, but significantly higher for SBP reductions > 70 mmHg. Similar J-shape associations were evident across various time epochs across 24 h and consistent according to baseline hematoma volume and SBP and history of hypertension. Interpretation: A moderate degree of rapid SBP lowering is associated with improved functional outcome after ICH, but large SBP reductions over 1 h (e.g. from > 200 to target < 140 mmHg) were associated with reduction, or reversal, of any such benefit.

Methodological Aspects of Meta-Analyses Assessing the Effect of Blood Pressure–Lowering Treatment on Clinical Outcomes

Systematic reviews and meta-analyses are often considered the highest level of evidence, with high impact on clinical practice guidelines. The methodological literature on systematic reviews and meta-analyses is extensive and covers most aspects relevant to the design and interpretation of meta-analysis findings in general. Analyzing the effect of blood pressure–lowering on clinical outcomes poses several challenges over and above what is covered in the general literature, including how to combine placebo-controlled trials, target-trials, and comparative studies depending on the research question, how to handle the potential interaction between baseline blood pressure level, common comorbidities, and the estimated treatment effect, and how to consider different magnitudes of blood pressure reduction across trials. This review aims to address the most important methodological considerations, to guide the general reader of systematic reviews and meta-analyses within our field, and to help inform the design of future studies. Furthermore, we highlight issues where published meta-analyses have applied different analytical strategies and discuss pros and cons with different strategies.

Ultrasound-Guided Lauromacrogol Injection for the Treatment of Active Bleeding After Renal Biopsy

Background: This study aimed to describe the technique and outcomes of hemostasis for ultrasound-guided lauromacrogol injection for active bleeding after renal biopsy.Methods: Data from patients with active bleeding after renal biopsy between January 2018 and December 2020 were retrospectively collected. Patients who still had active bleeding after 30 min of compression were then injected with lauromacrogol under ultrasound guidance. The patient’s symptoms before and after operation were collected to assess whether they had severe complications. Changes in hemoglobin and serum creatinine values were collected.Results: Data from a total of 15 patients with active bleeding after renal biopsy were collected, including data of 6 men and 9 women. After the operation, there were 11 cases of mild back pain; 1 case of chills, cold sweats, and back pain; 1 case of cold sweats and blood pressure reduction, and 2 cases with no obvious symptoms. No severe complications occurred in this study, and active bleeding was stopped in all patients. After the operation, compared with before the operation, there was no statistically significant difference in the hemoglobin value and serum creatinine value (p = 0.10 &gt; 0.05, p = 0.78 &gt; 0.05).Conclusion: Ultrasound-guided lauromacrogol injection is a relatively simple, safe and feasible method, which could be helpful in treating active bleeding in the immediate post-procedure period after renal biopsy.

Pengaruh Pemberian Daun Kelor Terhadap Penurunan Tekanan Darah Pada Penderita Hipertensi Lansia Selama Masa Pandemi Covid-19

Hipertensi menjadi salah satu penyakit yang menjadi faktor risiko terbesar kematian. Hipertensi menjadi penyakit penyerta yang banyak di temukan pada penderita COVID-19. Sekitar 15% kasus hipertensi yang terdapat pada pasien COVID-19 dan kejadian hipertensi mayoritas terjadi pada usia lansia sebesar 54,60%. Diperlukan suatu tindakan non farmakologi untuk menurunkan tekanan darah salah satunya dengan daun kelor. Tujuan penelitian ini untuk mengetahui pengaruh pemberian daun kelor terhadap penurunan tekanan darah pada penderita hipertensi lansia selama masa pandemi covid -19 di Kabupaten Grobogan. Metode penelitian kuantitatif dengan rancangan quasy eksperimen with control group design. Pengambilan sampel adalah non probability sampling dengan teknik qouta sampling (Judgement Sampling). Hasil diperoleh rata rata penurunan tekanan darah sistole adalah 16,00 dan hasil signifikansi dari perbedaan didapatkan r (0,000) < α (0,05). rata-rata penurunan tekanan darah diastole adalah 14,33 dengan hasil signifikansi dari perbedaan didapatkan r (0,000) < α (0,05) yang artinya ada pengaruh pemberian daun kelor terhadap penurunan tekanan darah. Simpulan terdapat perbedaan penurunan tekanan darah pada kelompok perlakuan dan kelompok kontrol pada lansia hipertensi di kabupaten Grobogan.Kata Kunci : hipertensi; lansia; daun kelorThe Effect Of Moringa Oleifera Leaf On Blood Pressure Reduction In Elderly With Hypertension Patients During The Covid-19 PandemicsAbstractHypertension is one of the diseases that are the biggest risk factor for death. Hypertension is a comorbid disease that is often found in patients with COVID-19. About 15% of hypertension cases found in COVID-19 patients and the majority of hypertension cases occurred in the elderly at 54.60%. A non-pharmacological action is needed to lower blood pressure, one of which is Moringa Oleifera leaves. The purpose of this study was to determine the effect of giving Moringa Oleifera leaves on reducing blood pressure in elderly hypertensive patients during the COVID-19 pandemic in Grobogan Regency. Quantitative research method was used with a quasi-experimental design control group design. The sampling technique was Non Probability Sampling with Qouta Sampling technique (Judgement Sampling). The results obtained that the average decrease in systolic blood pressure was 16.00 and the significance of the difference was  (0.000) (0.05). The average decrease in diastolic blood pressure was 14.33 with the results of the significance of the difference obtained (0.000) (0.05) which means that there is an effect of giving Moringa Oleifera leaves to decrease blood pressure. In conclusion, there are differences in blood pressure reduction in the treatment group and the control group in the elderly with hypertension in Grobogan district. Keywords: hypertension, elderly, moringa leaf.