A pilot study investigating the relationship between heart rate variability and blood pressure in young adults at risk for cardiovascular disease

Background Cardiovascular disease is one of the leading causes of death globally with hypertension being a primary cause of premature death from this disease process. Individuals with a family history of cardiovascular disease and hypertension are at a greater risk for developing the same sequela. Autonomic cardiac control is important in the level of cardiac function. One intervention that is effective in improving cardiovascular function is heart rate variability biofeedback training. The purpose of our study was to determine the effectiveness of heart rate biofeedback training on HRV and blood pressure in individuals with a family history of cardiovascular disease. Methods Thirty-four participants (76.5% female, 22.7 ± 4.3 years) completed a baseline assessment and training using an established short-term HRV protocol followed by two weeks of at-home paced breathing employing a smartphone application. The participants were then reassessed in a biofeedback clinic. Results The participants physiological measures showed a significant increase in means between pre and post intervention of SDNN (t (32) = 2.177, p =.037) and TP, (t (32) = 2.327 p = .026). Correlation noted a medium effect on diastolic blood pressure and high frequency heart rate variability, F, r = .41, n =33, p < .05. A multiple regression with all predictor variables in the model found no significance with diastolic and systolic blood pressure. Conclusions The findings from this pilot study demonstrated that a two-week paced breathing intervention may assist in reducing heart rate and diastolic blood pressure while improving heart rate variability.

Diabetes mellitus is associated with worse baseline and less post-treatment recovery of arterial stiffness in patients with primary aldosteronism

Background: Aldosterone excess in primary aldosteronism (PA) has been linked to insulin resistance, and diabetes mellitus has been associated with increased arterial stiffness and worse cardiovascular outcomes. However, the impact of diabetes on baseline and post-treatment arterial stiffness in patients with PA is unknown. Methods: This study prospectively enrolled 1071 PA patients, of whom 177 had diabetes and 894 did not. Clinical, biochemical, and brachial-ankle pulse wave velocity (baPWV) data were analyzed at baseline and 1 year after PA-specific treatment. After propensity score matching of age, sex, body mass index, systolic and diastolic blood pressure, hypertension duration, and number of antihypertensive medications, 144 patients with diabetes and 320 without diabetes were included for further analysis. Results: After propensity score matching, the baseline characteristics were balanced between the diabetes and nondiabetes groups except for fasting glucose, HbA1c, and lipid profiles. The patients with diabetes had significantly worse baseline baPWV compared with those without diabetes. After multivariable linear regression, the presence of diabetes mellitus remained a significant predictor of worse baseline mean baPWV (β: 46.3, 95% confidence interval: 2.9–89.7, p = 0.037). After 1 year of PA-specific treatment, only the nondiabetes group had significant recovery of mean baPWV (1661.8 ± 332.3 to 1565.0 ± 329.2 cm/s, p < 0.001; Δ = −96.8 ± 254.6 cm/s). In contrast, the diabetes group had less improvement (1771.2 ± 353.8 cm/s to 1742.0 ± 377.2 cm/s, p = 0.259; Δ = −29.2 ± 263.2 cm/s) even though the systolic and diastolic blood pressure significantly improved in both groups. Conclusion: The presence of diabetes mellitus in PA patients was associated with worse baseline and less post-treatment recovery of arterial stiffness.

PEMBERIAN LANCAU WOLIO TERHADAP PENURUNAN TEKANAN DARAH LANSIA

The Comparative Study of the Lancau Wolio Giving to Lowering Blood Pressure of Elderly Hypertension in Katobengke Public Health Center working area in 2020. The purpose of this study was to determine the effectiveness of Lancau Wolio potion in lowering blood pressure of elderly hypertension compared to other medication. The research was a quantitative approach and a quasi-experimental that compares the results of the intervention group and the control group. The intervention group comsume the Lancau Wolio and the control group taking medical drugs (Captopril) in lowering blood pressure. The results of this study showed a decrease of systolic blood pressure on the intervention group after consuming Lancau Wolio for two weeks (p = 0.003) and there was no difference in diastolic blood pressure on the intervention group before and after treatment (p = 0.255).In this study, Lancau Wolio was proven to be an alternative medication for hypertension which is effective in reducing systolic blood pressure by 9.32% on intervention group of elderly in Katobengke Public Center working area..

Induction of labor versus expectant management of patients with gestational hypertension at term.

Objective: To compare maternal morbidity in planned induction of labour versus expectant management in women with gestational hypertension at term. Study Design: Randomized Clinical Trial. Setting: Department of Obstetrics and Gynecology, Bolan Medical Complex Hospital Quetta. Period: January 2017 to December 2017. Material & Methods: 240 pregnant women with the diagnosis of gestational hypertension with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg without proteinuria were included. Patients were equally divided into two groups; group A (the intervention group) and group B (the expectant group). In group A, cervical ripening was stimulated with use of intravaginal prostaglandins. In group B, patients were monitored until the onset of spontaneous Labour. In both groups intervention was recommended in case of non-optimal FHR, the diastolic blood pressure ≥110mmHg or the systolic blood pressure ≥170 mmHg and eclampsia. Results: Out of 120 deliveries, 87 (72.5%) delivered by vaginal and 33 (27.5%) by caesarean section in group A. While in group B, out of 120 deliveries, 66 (55%) delivered by vaginal and 54 (45%) by caesarean section. The frequency of maternal outcome like mild preeclampsia present in 15% and 40% of women in group A and in group B respectively. Severe preeclampsia was noted 7.5% and 22.5% in group A and in group B respectively. Seizures were found in 2.5% of women in group A and 10% of women in group B. Conclusion: Complications like mild and severe preeclampsia and eclampsia could be prevented by induction of labour at term and also by widespread use of prenatal care education, prompt diagnosis and treatment of gestational hypertension.

Fasting Blood Glucose Level Progression And Its Associated Factors Among Diabetic Patients Attending Treatment In North Shewa Hospitals, Oromia, Ethiopia

Background: Diabetes describes a group of metabolic disorders characterized and identified by hyperglycemia without treatment. It includes defects in insulin secretion, insulin action, or both, and disturbances of carbohydrate, fat, and protein metabolism. The study aimed to assess fasting blood glucose level progression and its associated factors among diabetic patients attending insulin and metformin follow-up in fiche and Chancho hospitals.Methods: A retrospective study was conducted to obtain secondary data among diabetic patients attending treatment from September 2016 to August 2018 in the hospital. The linear- mixed effects model for longitudinal data was employed to measure the changes in fasting blood glucose level.Result: The result of the study revealed that age, body mass index, systolic blood pressure, diastolic blood pressure, marital status, regime, and education level were significantly associated factors for the progression of fasting blood glucose levels among diabetic patients. Conclusion: The study recommended that the progression of blood glucose level was higher among diabetic patients, and the health professionals, health sectors, and government should be paid an intervention on patients who had high systolic and diastolic blood pressure, who had high BMI, and older age patients.

Terapi SEFT (Spiritual Emotional Freedom Technique) Sebagai Upaya Penurunan Hipertensi Pada Lansia: Literature Review

Spiritual Emotional Freedom Technique (SEFT) is a relaxation technique which is a form of mind-body-therapy from complementary and alternative therapies. SEFT works by activating the body's meridian pathways by light tapping on 9 or 18 meridian points of the body, with the mind and heart concentrating on the place and the pain that we feel accompanied by prayer. The study aimed to examine the effect of SEFT therapy on blood pressure in the elderly with hypertension. The study applied a literature review. By using the keywords "SEFT, Hypertension, Elderly" the articles were searched from GARUDA and Google Scholar databases. The articles that published in period of 2011 to 2021 and fit with the inclusion and exclusion criteria were reviewed. The quality of articles was assessed using CONSORT checklist. The results show that the mean systolic and diastolic blood pressure before SEFT therapy was 163 mmHg and 93 mmHg, respectively. Meanwhile, the mean systolic and diastolic blood pressure after SEFT therapy was 154 mmHg and 88 mmHg, respectively. There is a significant effect of SEFT therapy on reducing blood pressure in the elderly with hypertension. SEFT therapy is effective and can be applied as a complementary therapy in reducing blood pressure in the elderly. Based on the results, SEFT therapy can be socialized to the wider community and can be applied as an alternative therapy to reduce blood pressure in hypertensive patients.Keywords: Elderly, Hypertension, SEFT AbstrakSpiritual Emotional Freedom Technique (SEFT) merupakan teknik relaksasi yang merupakan salah satu bentuk mind-body-therapy dari terapi komplementer dan terapi alternatif. SEFT bekerja dengan mengaktifkan jalur-jalur meridian tubuh dengan cara ketukan ringan atau tapping di 9 atau 18 titik meridian tubuh, dengan pikiran dan hati konsentrasi pada tempat dan rasa sakit yang kita rasakan disertai dengan doa. Untuk mengetahui pengaruh terapi SEFT terhadap tekanan darah pada lansia. Penelitian ini menggunakan literature review, dengan pencarian artikel menggunakan database garba garuda dan google scholar untuk menemukan artikel yang sesuai kriteria inklusi dan eksklusi dengan memasukan kata kunci “SEFT, Hipertensi, Lansia” dalam periode 2011-2021. Instrument untuk menilai kualitas artikel menggunakan CONSORT Instrumen. Hasil literature review menunjukan mean tekanan darah systole dan diastole sebelum dilakukan terapi SEFT adalah 163 mmHg dan 93 mmHg. Sedangkan mean tekanan darah systole dan diastole setelah dilakukan terapi SEFT adalah 154 mmHg 88 mmHg. Terdapat pengaruh yang signifikan terapi SEFT terhadap penurunan tekanan darah pada lansia lansia dengan hipertensi.Terapi SEFT efektif dan dapat diterapkan sebagai terapi komplementer dalam penurunan tekanan darah pada lansia. Berdasarkan hasil penelitian ini terapi SEFT dapat disosialisasikan kepada masyarakat luas dan dapat diterapkan sebagai terapi alternatif untuk menurunkan tekanan darah pada pasien hipertensi.Kata kunci: SEFT; Lansia;Hipertensi

Stress system dysfunction revealed by integrating reactivity of stress pathways to psychological stress in lean and overweight/obese men

While the patterns of response within the sympatho-adrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems that is not evident when considering either system alone. Age matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary alpha amylase, systolic blood pressure, diastolic blood pressure and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. While analysis of reactivity of individual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Further, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation of the other.

Association between Sleep Time and Blood Pressure in Korean Adolescents: Cross-Sectional Analysis of KNHANES VII

Background: Hypertension is highly related to sleep, and there have been a number of studies on sleep deprivation and the occurrence of hypertension. However, there is still insufficient research on the relationship between hypertension and various factors related to sleep. Thus, this study attempted to investigate the relationship between hypertension and sleep time-related variables in Korean adolescents. Methods: A total of 1470 adolescents (709 girls and 761 boys) between 12 and 18 years of age were enrolled through the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). The systolic and diastolic blood pressure were measured. Sleep time-related variables such as sleep onset time, wake time, and sleep duration (weekday and weekend, each) were also investigated using a questionnaire. We performed multivariate regression analyses to determine the independent effects of the variables. Results: Systolic blood pressure was negatively correlated with the wake time (r = −0.081; p = 0.002) and sleep onset time (r = −0.088; p = 0.001) on weekends. There was a positive correlation between diastolic blood pressure and weekday sleep onset time (r = 0.158; p = 0.000) and weekend sleep onset time (r = 0.184; p = 0.000). The sleep duration on weekdays and weekends showed a negative correlation (r = −0.136; p = 0.000, r = −0.088; p = 0.001, respectively). In the multivariate linear regression analysis results, the sleep onset time on weekends was significantly correlated with elevated diastolic blood pressure. Conclusions: Delayed sleep onset time on weekends was significantly associated with increased diastolic blood pressure in Korean adolescents. Further investigation is needed to confirm the clinical significance of these findings.

Effects of Yogic practices on cardiovascular system and salivary alpha amylase on Indian healthy jail inmates

Objectives Imprisoned people usually have a poor health status and an increase risk to suffer chronic debilitating conditions, co-infection due to their limitations in physical activity and mental disturbances. This study was carried to find out the health impacts of Yogic practice of Indian healthy jail inmates. Methods It was interventional single group pre-post design study. A total no of 30, Jail inmates including 08 female were participated in this study and practiced Yoga for six months. Body Mass Index, Heart Rate, Blood Pressure, Salivary alpha amylase activity (SAA) a stress marker were assessed before, after three months and after completion of six months of Yogic practice. Results Improvement was noted in all parameters, but significant improvement was noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in total participants. Significant improvement was also noted in systolic blood pressure, diastolic blood pressure, mean blood pressure, double product a index of load in the heart and SAA following Yogic practice in male group. No significant effect was noted in female group. Conclusions The present study revealed that regular Yogic practice resulted in reduction blood pressure, load in the heart and stress in mail jail inmates, when it is practiced regularly and carefully.