Visit-to-Visit Blood Pressure Variability and Longitudinal Tau Accumulation in Older Adults

Background: Elevated blood pressure variability (BPV) is predictive of dementia, independent of average blood pressure levels, but neuropathological mechanisms remain unclear. We examined whether BPV in older adults is related to tau accumulation in brain regions vulnerable to Alzheimer disease and whether relationships are modified by apoϵ4 carrier status. Methods: Two hundred eighty-six Alzheimer’s Disease Neuroimaging Initiative participants without history of dementia underwent 3 to 4 blood pressure measurements over 12 months and ≥1 tau positron emission tomography thereafter. BPV was calculated as variability independent of mean. Each scan determined tau burden (standardized uptake value ratio) for a temporal meta–region of interest, including burden from entorhinal cortex, amygdala, parahippocampus, fusiform, inferior temporal, and middle temporal. Bayesian linear growth modeling examined the role of BPV, apolipoprotein ϵ4 carrier status, and time on regional tau accumulation after controlling for several variables, including baseline hypertension. Results: Elevated BPV was related to tau accumulation at follow-up in a temporal meta-region, independent of average blood pressure levels (ß, 0.89 [95% credible interval, 0.86–0.92]) and especially in entorhinal cortex (ß, 2.57 [95% credible interval, 2.15–2.99]). Apoϵ4 carriers with elevated BPV had the fastest tau accumulation at follow-up (ß, 1.73 [95% credible interval, 0.47–3.03]). Conclusions: BPV is related to tau accumulation in brain regions vulnerable to Alzheimer disease, independent of average blood pressure. APOEϵ4 modified this relationship. Bidirectionality of findings is possible. BPV may represent a marker of vascular dysfunction related to early-stage tau pathology contributing to Alzheimer disease.

Аrterial stiffness and diastolic function of the left ventricle in patients with arterial hypertension and frailty

Introduction. Increased arterial stiffness is one of the key links in the formation of cardiovascular pathology in older age groups. At the same time, the effect of vascular stiffness on myocardial function in cardiac patients with frailty remains insufficiently studied.Aim of study. Тo analyze the data of arterial stiffness and diastolic function of left ventricle (LV) in patients older than 65 years with arterial hypertension and frailty.Materials and methods. The study included 90 outpatient and inpatient patients older than 65 years with the presence of arterial hypertension. All patients were divided into two groups: with the presence and absence of frailty. To identify frailty, we used the questionnaire “Age is not a hindrance”, a short battery of physical activity tests. Methods of volumetric sphygmometry, echocardiography, including tissue Doppler were used. The obtained data were analyzed using a package of statistical programs.Results. The results of a comparative simultaneous non-randomized descriptive study of two groups of patients are presented. The study found that the systolic function, diastolic dysfunction of the left ventricle by the type of slowing down of LV relaxation in both groups did not significantly differ in their indicators. In the group of patients with frailty, LV diastolic dysfunction was significantly more often detected by the type of pseudonormalization – with an increase in filling pressure. When analyzing data of arterial stiffness, differences were obtained in both groups in the left cardio-ankle vascular index (LCAVI), systolic blood pressure (LB SAD), pulse pressure (LB PD) in the left shoulder area, and the delta of average blood pressure in the left ankle area (LA% IDA), which were significantly higher in patients with frailty.Conclusion. In the group of patients with hypertension older than 65 years with frailty, a violation of the LV diastolic function by the type of pseudonormalization with an increase in filling pressure prevails. An increase in filling pressure in the group of patients older than 65 years with hypertension and the presence of frailty is associated with an increase in the complex of indicators characterizing arterial stiffness – the cardio-ankle vascular index, systolic blood pressure, pulse pressure in the left shoulder area, the delta of average blood pressure in the left ankle area.

Pengaruh terapi musik klasik (mozart) terhadap tekanan darah pada lansia dengan hipertensi

The effect of classic music therapy (mozart) on blood pressure in elderly with hypertensionBackground: Based on the Health Profile of North Lampung Regency in 2018 the number of people with hypertension in the last three years increased to 600 in 2017 and in 2018 the number of sufferers was 741 sufferers.Purpose: To determine the effect of classical music therapy (Mozart) on blood pressure.Method: Quantitative research uses a quasi-experimental approach. The population was patients with hypertension at the Elderly Post health service (Posyandu) at Kalibalangan Health Center, which amounts to 80 people. A sample of 62 participants divided into 2 groups, 31 participants by music therapy + antihypertensive drug (amlodipine), and 31 other participants only take the antihypertensive drug as amlodipine. Data collection techniques by monitoring of blood pressure. The statistical test used is the Independent Test.Results:The average blood pressure of systole before being given Classical Music (Mozart) + Amlodiphine is 164.2 mmHg, diastole 102.7 mmHg. The average blood pressure of systole before being given Amlodipine is 163.5mmHg, diastole 103.9 mmHg. Average blood pressure of systole after given Classical Music (Mozart) + Amlodipine is 147.1mmHg, diastole 89.03mmHg. The mean systole blood pressure after Amlodipine is 152.3mmHg, diastole 95.2 mmHg. There are differences in systolic blood pressure in patients with moderate hypertension between the intervention groups (classical music therapy (mozart) ) and the control group (p-value = 0,000) There is a difference in diastolic blood pressure in patients with moderate hypertension between the intervention group (classical music therapy (mozart) and the control group (p value = 0.016).Conclusion: There is an influence of classical music therapy (mozart) on blood pressure, it is recommended to use the results of this study as an alternative therapy in the treatment of primary hypertension and so that it can be socialized to the communityKeywords: Classical Music Therapy (Mozart); Blood Pressure; Hypertension; ElderlyPendahuluan: Jumlah penderita hipertensi di Kabupaten Lampung Utara dalam tiga tahun terakhir mengalami peningkatan tahun 2015 sebesar 10.743 penderita tahun 2016 sebesar 13.039 penderita dan tahun 2017 sebesar 11.228 penderita. Sementara di Puskesmas Kalibalangan tahun 2015 sejumlah 604 turun menjadi 458 tahun 2016, kemudian meningkat menjadi 600 tahun 2017 dan tahun 2018 sejumlah 741 pasien, musik klasik merupakan salah satu terapi non farmakalogik yang mampu menurunkan tekanan darah.Tujuan: Diketahui pengaruh terapi music klasik (Mozart) terhadap tekanan darah pada lansia.Metode: Penelitian kuantitatif menggunakan pendekatan eksperimen semu. Populasi dalam penelitian ini adalah penderita hipertensi di Posyandu Puskesmas Kalibalangan yang berjumlah 80 orang. Sampel sebanyak 62 partisipan dibagi menjadi 2 kelompok, 31 partisipan dengan terapi musik + obat anti hipertensi (amlodipine), dan 31 partisipan lainnya hanya mengkonsumsi obat anti hipertensi sebagai amlodipine. Teknik pengumpulan data dengan mengamati tekanan darah. Uji statistik yang digunakan adalah Independent Test.Hasil: Rata-rata tekanan darah systole sebelum diberi Musik Klasik (Mozart) + Amlodiphine adalah 164.2 mmHg, diastole 102,7 mmHg, pada kelompok yang diberi Amlodipine adalah 163.5mmHg, diastole 103.9 mmHg. Rata-rata tekanan darah systole sesudah diberi Musik Klasik (Mozart) + Amlodipine adalah 147.1 mmHg, diastole 89.03 mmHg, pada kelompok yang diberi Amlodipine adalah 152.3 mmHg, diastole 95.2 mmHg. Ada perbedaan tekanan darah sistolik pada penderita hipertensi sedang antara kelompok intervensi (terapi music klasik (mozart) dan kelompok control (p-value = 0,000). Ada perbedaan tekanan darah diastolic pada penderita hipertensi sedang antara kelompok intervensi (terapi music klasik (mozart) dan kelompok control (p value =0,016).Simpulan: Ada pengaruh terapimusik klasik (Mozart) terhadap tekanan darah pada lansia, sehingga disarankan agar menggunakan hasil penelitian ini sebagai salah satu terapi alternative dalam pengobatan hipertensi primer dan agar dapat disosialisasikan kepada masyarakat.

The methodology of organizing the training process of athletes and daily regime

The daily regime is the most important component of the training of hand-to-hand athletes, which has a significant impact on the body functioning and its state and the whole training process to competitions. The study substantiates the statement that for strengthening physical and mental health, as well as for the sufficient recovery after training, it is necessary to adhere the established rational daily regime, built taking into account the peculiarities of the training process. A rational daily regime allows athletes to follow the optimal rhythm of activity and, therefore, it is easier to cope with the proposed physical activity before and during the competitions. The article presents the data of the researches concerning the changes in the body functioning of hand-to-hand combatants throughout the day, covers the issues about creating the training process and the daily regime at the period of the preparation for various competitions. Such indicators as the time of motor reaction and its latent and motor components, parameters of the maximum muscle strength and muscle strength asymmetry, the data of the maximum and average blood pressure, heart rate, etc. were measured.The optimal time of the functional state of hand-to-hand athletes was determined, focusing on which the training process and the entire daily regime are created.

RISK OF ARTERIAL HYPERTENSION DEVELOPMENT IN STUDENTS WITH CHRONIC PYELONEPHRITIS

Исследование и сравнительный анализ результатов суточного мониторирования артериального давления (АД) и пульса (Ps) было проведено у 63 студенток первого курса медицинского колледжа в зависимости от наличия у них подтвержденного диагноза хронический пиелонефрит в стадии ремиссии. Обследование участниц исследования проводилось в соответствии с Протоколами диагностики и лечения хронического пиелонефрита» РК. При этом показатель АД и Ps, определенный в автоматическом режиме тонометром фирмы «OMRON», у всех участниц исследований соответствовал 5-90 перцентилям с учетом их возраста и гендерной принадлежности. Критериями для анализа, при проведении нашего исследования являлись: САД - систолическое артериальное давление; ДАД - диастолическое артериальное давление; ЧСС (соответствующая Ps); СрАД - средние показатели артериального давления в измеряемом интервале (за 24 часа, за дневной и ночной интервал отдельно), показатели «нагрузки давлением» (индекс времени гипертензии - ИВ, индекс площади гипертензии - ИП) за сутки, день и ночь; вариабельность АД; суточный индекс - СИ (степень ночного снижения АД). The study and comparative analysis of the results of 24-hour monitoring of blood pressure (BP) and pulse (Ps) were carried out in 63 first-year medical college students, depending on whether they had a confirmed diagnosis of chronic pyelonephritis in remission. The examination of the study participants was carried out according to the Protocols for the diagnosis and treatment of chronic pyelonephritis of RK. At the same time, the blood pressure and Ps index, determined in automatic mode by the “OMRON” tonometer, corresponded to 5-90 percentiles in all the research participants, taking into account their age and gender. The criteria for the analysis in our study were: SBP - systolic blood pressure; DBP - diastolic blood pressure; Heart rate (corresponding to Ps); ABP - average blood pressure in the measured interval (for 24 hours, day and night intervals separately), indicators of "pressure load" (hypertension time index- TI , hypertension area index - AI) per day, day and night; variability of blood pressure; daily index - DI (the degree of night blood pressure decrease).

Cucumber and honey soaking reduces hypertension in the elderly

Hypertension is a condition of increasing a person's blood pressure beyond normal limits, causing increased morbidity and mortality. Hypertension can be reduced by consuming cucumber which contains potassium which inhibits the release of renin so that there is an increase in sodium and water excretion. In addition, it can also be reduced by consuming honey which can prevent the formation of plaque attached to the walls of blood vessels so that it can eliminate bad cholesterol for the body. This study aimed to determine the effect of giving cucumber and honey water immersion on Elderly Hypertension. This study used a Quasy Experimental design with a Pretest and Posttest with Control Group design. Sampling using a simple random sampling technique. The sample in this study amounted to 30 elderly people using the paired sample t-test statistical test. The results showed that the average blood pressure of the intervention group before being given the cucumber and honey water immersion was 153.6/84 mmHg and after it was 148.3/82.1 mmHg. The average blood pressure of the control group before being given the cucumber and honey water immersion was 158.5/80.2 mmHg and after it was 163.5/80.2 mmHg with p = 0.000. In the results of the independent sample test the intervention group before being given therapy, namely Sig. (2-tailed) = 0.027, the control group before treatment was Sig. (2-tailed) = 0.045. While the test results of the intervention group after being given therapy are Sig. (2-tailed) = 0.124, the control group after being given therapy is Sig. (2-tailed) = 0.139. There is an effect of giving cucumber and honey water immersion therapy on changes in blood pressure in the elderly with hypertension. But there is no difference in the average blood pressure of the Hypertensive Elderly. It is expected that the elderly with hypertension can make cucumber and honey water immersion as an alternative therapy to reduce hypertension

Abstract P212: Comparison Of Vascular Risk Factors And Serum Fatty Acids At Admission Between Intracerebral Hemorrhage And Acute Ischemic Stroke

Introduction: Dietary triglycerides influence fatty acid (FA) serum concentrations and weight percentages (wt%), which may be associated with the onset of intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS). Hypothesis: There are significant differences between FAs at the admission of ICH and AIS. Methods: We included patients admitted between 2016 and 2019 within 24 h of ICH or AIS onset and calculated correlation coefficients between their ages, serum FA concentrations, and FA wt% values. We evaluated differences in age, average blood pressure (ABP), glucose, A1c, serum lipids, and FAs between two groups. Excluding variables with multicollinearity, we performed multiple logistic regression (MLR) analysis to identify independent variables distinguishing ICH from AIS. We estimated the threshold values of independent variables using the area under the curve values derived from the receiver operating characteristic (ROC) curves. Results: Our inclusion criteria were met by 141 of ICH patients and 525 of AIS patients. In the ICH group, age, A1c, and eicosapentaenoic acid (EPA) levels were smaller than those in the AIS group. ABP, high-density lipoprotein cholesterol (HDL-C), myristic acid (MyA), linoleic acid (LiA) concentrations, and MyA wt% were higher than those in the AIS group. MLR analysis between two groups indicated that age, ABP, A1c, HDL-C were independent variables. Serum FA levels were not independent. ROC curves showed that the threshold values of age, ABP, A1c, and HDL-C for ICH onset were ≤ 69 years, ≥ 126.6 mmHg, ≤ 6.0%, and ≥ 1.62 mmol/L, respectively. In 27 patients with age ≤ 69 , ABP ≥ 126.6, A1c ≤ 6.0%, and HDL-C ≥ 1.62 and 87 patients with age > 69 , ABP< 126.6, A1c > 6.0, and HDL-C < 1.62, there were 19 (70.4%) and 9 (10.3%) patients with ICH, the MyA concentrations were 108 and 73 μmol/L (p < 0.001), the LiA concentration were 2,900 and 2,410μmol/L (p < 0.001), and the EPA wt% were 1.4 and 2.0% (p=0.059), respectively. Conclusions: Younger patients with higher ABP, lower A1c, and higher HDL-C suffered from not AIS but ICH, and their MyA and LiA concentrations were higher than older patients without them.

Differential Responses of Resistance Arterioles to Elevated Intraluminal Pressure in Blacks and Whites

Black Americans have an earlier onset, higher average blood pressure, and higher rates of hypertension-related mortality and morbidity, compared to whites. The racial difference may be related to microvasculature, the major regulatory site of blood pressure. The goal of this study was to compare the response of resistance vessels to high intraluminal pressure between black and white participants. A total of 38 vessels were obtained from human fat samples (21 black, 17 white; mean age 32 ± 12 years and BMI 26.9 ± 4.9; between-group P ≥ 0.05) and included in this study. Internal diameter was measured in response to flow induced by various pressure gradients (Δ10, Δ20, Δ40, Δ60, and Δ100 cmH2O), and flow-induced dilation (FID) was calculated before and after high intraluminal pressure (150 cm H2O). Prior to high intraluminal pressure, FID was not different between blacks and whites (P = 0.112). After exposure to high intraluminal pressure, FID was reduced at every pressure gradient in vessels from blacks (P < 0.001), while FID did not change in white participants except at Δ 100 cmH2O. When incubated with the H2O2 scavenger PEG-catalase, the FID response in vessels from black, but not white, individuals was significantly reduced and the magnitude was higher at normal pressure relative to high pressure. Our findings suggest that vessels from self-identified black individuals are more susceptible to microvascular dysfunction following transient periods of high intraluminal pressure compared to whites and show greater dependence on H2O2 as a main contributor to FID at normal pressures.

A comprehensive overview of the diagnosis and treatment of hypertension based on the latest hypertension guidelines

In recent years, non-communicable diseases (NCDs) have accounted for about 70% of the world's deaths. The most common NCDs are cardiovascular disease, cancer, diabetes mellitus, and chronic respiratory diseases. These diseases have four common risk factors, including inadequate physical activity, unhealthy diet, smoking, and excessive alcohol consumption. Cardiovascular diseases, despite their high prevalence, are the most preventable chronic diseases. The most common risk factor for cardiovascular disease is high blood pressure, which can be prevented if it is diagnosed and controlled carefully. Recent guidelines have changed the methods of blood pressure measurement, definition, and treatments. Recently, more emphasis has been placed on Out-of-Office Blood Pressure Measurement. Therefore, it is necessary to consider the methods of measuring blood pressure at home and 24-hour Holter blood pressure monitoring, as well as understanding its standards. The use of automatic arm sphygmomanometers to measure blood pressure is more acceptable than manual ones (mercury or Aneroid). The most accepted definitions of hypertension are BP≥140/90 mm Hg in the clinic, the average blood pressure at home≥135/85 mm Hg, and the average blood pressure in 24-hour Holter monitoring≥130/80 mm Hg. Proper treatment of hypertension by changing lifestyle and proper medication therapy can control blood pressure and prevent serious complications. Today, the use of combination drugs, especially a single pill in a single dose, has been emphasized. This study aimed to review the most recent hypertension treatment protocols based on the guidelines of the American Heart Association (AHA 2017), the European Society of Cardiology (ESC 2018), the British Heart Association (NICE 2019), and the International Society of Hypertension (ISH 2020). Furthermore, this study attempted to assess the symptoms, complications, methods of diagnosing, definitions, as well as pharmacological and non-pharmacological treatments of hypertension.

Comparison of blood pressure in shoulder and femoral area

Failure to measure blood pressure on the brachial artery forces us to look for other areas to obtain values with non-invasive blood pressure measurement. The femoral area can be regarded as such an alternative. Therefore, establishing the reliability of the relationship between blood pressure values measured in the shoulder and femoral areas is a promising area of research. In this study, blood pressure measurements were carried out at rest in 100 soma-tically healthy students aged 21.0 ± 1.2 years by means of a patient monitor UM-300 (Ukraine) using two standard cuffs for shoulder (25–35 cm) and femoral areas (38–50 cm). The statistical validity of the relationship was determined using the Bland-Altman me-thod, and elements of regression analysis were used. The results of the study showed no significant discrepancy in the data, especially when it came to average blood pressure. A regression model has also been developed, which can serve as valuable information for the algorithmic development of programs for predicting blood pressure in the brachial artery when measuring it in the femoral area. Thus, measuring blood pressure in the femoral artery can be considered an alternative to measuring blood pressure in the shoulder area.