Search

Objective: improving the effectiveness of hypertension control in patients after COVID-19 with manifestations of depression. Materials and methods: the study included 48 patients with hypertension who had suffered a coronavirus infection. The criterion for inclusion in the study was effective control of blood pressure when using two-component antihypertensive therapy before the development of coronavirus disease and its absence when using the same therapy at the time of inclusion in the study. To identify the symptoms of depression, a study was conducted using the Beck Depression questionnaire. Group A consisted of patients with arterial hypertension with manifestations of depression and group B-patients with arterial hypertension without symptoms of depression. In both groups, a combination of a renin-angiotensin-aldosterone system blocker, a diuretic and a calcium channel blocker were used. The observation was carried out for 4 weeks, the dynamics of blood pressure and its daily parameters, manifestations of depression were evaluated. Results: the presence of symptoms of depression was detected in 39.5% of patients. At the time of inclusion in the study, office blood pressure exceeded the target level in all patients, there was an insufficient decrease in systolic and diastolic blood pressure during the day and at night, an increase in most indicators of blood pressure variability. The use of three-component therapy made it possible to achieve the target blood pressure level in 93.1% of patients without symptoms of depression. In the group of patients with depression, only 21.0% of patients reached the target blood pressure level. The analysis of daily blood pressure indicators showed a decrease in the effectiveness of antihypertensive therapy in the group of patients with depression. All daily blood pressure indicators were statistically significantly higher than in group B. Conclusion: in patients who have suffered a coronavirus infection, it is necessary to identify depression as a possible factor of ineffective control of arterial hypertension and a decrease in adherence to the recommended therapy.

The effect of antihypertensive medicine (AHM) is larger the higher the pre-treatment blood pressure level. It is unknown whether this Wilder’s principle, also applies for the exercise-training blood pressure (BP) lowering effect. One hundred seventy-eight (n=178) middle-aged individuals (55±8 y) with metabolic syndrome (MetS), underwent high intensity interval training (3 days·week–1) for 16 weeks. Participants were divided into medicated (Med; n=103) or not medicated (No Med; n=75) with AHM. Office BP was evaluated before and after the exercise-training. Correlations and stepwise regression analysis were used to determine which variable better predicted the reductions in systolic BP (SBP) with training. After training, participants with hypertension lowered SBP by a similar magnitude regardless of if they were in the Med (–15 mmHg, 95% CI–12,–19; P

To explore the application of natural convalescent factors combined with exercise intelligence management in blood pressure control of patients with hypertension, 102 patients with hypertension who were admitted from January 2017 to August 2019 were selected as the research subjects. According to the odd-even number method, they were divided into two groups with 51 cases in each group. The control group was treated with natural convalescent factor therapy alone, and the observation group was treated with natural convalescent factor combined with motor intelligence management. The application effects of the two groups were compared. Before sports intelligence management, the levels of systolic blood pressure (SBP) in control group and observation group were (145.45 ± 8.44) mmHg (1 mmHg = 0.133 kPa) and (146.55 ± 8.37) mmHg, respectively; the diastolic blood pressure (DBP) levels of the control group and the observation group were (98.47 ± 3.48) mmHg and (98.94 ± 3.48) mmHg, respectively, with no statistical significance ( P > 0.05 ). After the exercise intelligence management, the SBP levels of the control group and the observation group were (132.76 ± 4.48) mmHg and (130.06 ± 2.48) mmHg, respectively. The DBP levels of the control group and the observation group were (85.48 ± 5.38) mmHg and (83.47 ± 3.35) mmHg, respectively. The difference was statistically significant ( P < 0.05 ). The scores of each index of quality of life in the observation group were higher than those in the control group, and the differences of physical function and psychological/mental scores were significant. The scores of physical function in the two groups before administration were (48.36 ± 1.69) and (48.74 ± 1.62), and the differences were not statistically significant ( P > 0.05 ). After management, the physiological function scores of the two groups were (40.32 ± 1.33) and (32.15 ± 1.54) and the difference was statistically significant ( P < 0.05 ). There were no significant differences in the psychological (30.75 ± 1.26)/mental scores (30.26 ± 1.48) between the two groups before management ( P > 0.05 ), but there were significant differences in the psychological (25.30 ± 1.02)/mental scores (18.76 ± 1.36) between the two groups after management ( P < 0.05 ). The combination of natural convalescent factors and intelligent exercise management can effectively control the blood pressure level and improve the quality of life of patients with hypertension, and the clinical application effect is good.

Objectives As there is uncertainty about the extent to which baseline blood pressure level or cardiovascular risk modifies the relationship between blood pressure variability (BPv) and cardiovascular disease, we comprehensively examined the role of BPv in cardiovascular disease risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial. Methods Using data from ACCORD, we examined the relationship of BPv with development of the primary CVD outcome, major coronary heart disease (CHD), and total stroke using time-dependent Cox proportional hazards models. Results BPv was associated with the primary CVD outcome and major CHD but not stroke. The positive association with the primary CVD outcome and major CHD was more pronounced in low and high strata of baseline SBP ( 140 mmHg) and DBP ( 80 mmHg). The effect of BPv on CVD and CHD was more pronounced in those with both prior CVD history and low blood pressure. Dips, not elevations, in blood pressure appeared to drive these associations. The relationships were generally not attenuated by adjustment for mean blood pressure, medication adherence, or baseline comorbidities. A sensitivity analysis using CVD events from the long-term posttrial follow-up (ACCORDION) was consistent with the results from ACCORD. Conclusion In ACCORD, the effect of BPv on adverse cardiovascular (but not cerebrovascular) outcomes is modified by baseline blood pressure and prior CVD. Recognizing these more nuanced relationships may help improve risk stratification and blood pressure management decisions as well as provide insight into potential underlying mechanisms.

Background : Chronic Kidney Failure (CKD) is a kidney function disorder that occurs gradually, cannot be recovered, and describes a decrease in urine production which results in an accumulation of fluid in the body. This can disrupt their fluid and electrolyte balance. In this regard, in Indonesia there are still many phenomena of non-compliance with fluid monitoring that occur. If this is left unchecked, it will result in a condition of overload or excess fluid in the patient. Fluid management is needed to fulfill the patient's fluid and electrolyte needs, so that changes in body weight and the results of the calculation of fluid balance can be controlled and become an illustration of meeting these needs. Purpose : to explain nursing care to meet fluid and electrolyte needs in chronic kidney disease patients. Methods : nursing care was carried out on patients with a diagnosis of chronic kidney disease who have impaired fluid and electrolyte requirements. The nursing intervention used to overcome this problem was fluid management. Data were collected from interviews and observations and further analysis was carried out. Results : After three days nursing intervention, the results showed that the client's level of shortness of breath decreased, the blood pressure level was close to normal, fluid calculation close to balance, and the client's weight seemed stable. Conclusion : fluid management was effective for monitoring fluid intake and output of chronic kidney disease patient.

Introduction. In recent years, there has been anincrease in the prevalence of hypertension in both adults andchildren. The discrepancy in the prevalence of the diseasein children is associated with the absence of a standardizedmethod of measuring blood pressure, uniform criteria forassessing its level, as well as the "hypodiagnostics" ofarterial hypertension in children. Attention should alsobe paid to the relatively low compliance of some childrenand adolescents in the treatment and awareness of the needto maintain a sufficient level of physical activity, healthyeating and prevention of bad habits.The aim of the study was to determine the influence ofmicrosocial factors on the formation of arterial hypertensionin schoolchildren.Material and research methods. 848 school - agechildren were examined and divided into the followinggroups: the first group consisted of 182 children withhypertension, the second group - 78 children with arterialprehypertension and the control group - 588 children withnormal blood pressure.Sociometric survey was conducted by collectinginformation about the peculiarities of diet and quality ofnutrition, physical activity and psychological factors inchildren using questionnaires. Blood pressure level wasmeasured with automatic tonometers with variable cuffs inthe morning on both hands, three times, with an intervalof 2 minutes. The results were evaluated according topercentile tables in terms of age, sex and height. Statisticalprocessing of the obtained data was performed usingMicrosoftOfficeExcel and Statistica 10.0.Results. Analyzing the psychological atmospherewithin the family, it was found that 585 (69.0%) childrencalled the situation within the family good and warm, 100(12.1%) thought that family conditions were bad and 138(16.3%) children did not decide on account of bad or goodrelations within the family.Assessing the peculiarities of nutrition among thesurveyed schoolchildren, it was found that children fromthe 1st group ate the most irrationally. They ate bread andbaked goods more often every day, meat and dairy productsa little less often, and vegetables and fruits even less often.Equally important factors influencing a child’s healthand development are the presence of physical activity, dailyroutine, walks in the fresh air, and so on. Another importantfactor that affects both the general health of the child andhis physical development is regular exercise in sections orclubs.Children from the 1st group have the lowest level ofregular sports, unbalanced diet, and more often havepsychological problems in relationships with peers andparents. Given the data of statistical analysis, thesemicrosocial factors can be regarded as risk factors for thedevelopment of hypertension in schoolchildren.Conclusions. According to the conducted correlativeand cluster analysis, three key groups of microsocial factorsthat affect the level of blood pressure in children can beidentified: the factor of balanced nutrition, psychosocialfactor and the factor of physical activity. The abovefactors are complex, they can be classified to the categoryof risk factors for the development of hypertension inschoolchildren and early prediction of increased bloodpressure in them.

The aging process which happens in elder people has effects on blood pressure. The well maintenance of blood pressure will impact on elder people’s daily activities, included in increasing spirituality. This is the one factor which can control over blood pressure. This research uses cross sectional design with purposive sampling method which had been implemented for 70 elder people and got 33 respondents. Data were collected by giving questionnaire such as elder people charactheristic, Daily Spiritual Experimental Scale (DSES) and Sphygnomanometer used to measure blood pressure. Chi-Square Test by 0,05 significance values is examined as data analysis. The result indicates that the average value of spirituality level is Md 39 + 36-47,5 and the average value of blood pressure level is 160,52 systole and 97,09 diastole. Thus, the results also reveals relationship betwen spirituality level and blood pressure (p value 0,002). This study significance shows that the higher level of spirituality is, the easily elder people manage blood pressure. Therefore, elder people living in nursing home should increase the spirituality level or their religion to control blood pressure.

The aim. To evaluate the reliability of blood pressure (BP) measurement results using a cuffless blood pressure device (CardioQVARK®) in comparison with the values obtained using the Korotkov method.Materials and methods. An observational cross-sectional study of 50 patients (25 men, mean age 60 ± 14 years) with arterial hypertension was performed. Blood pressure was measured by the Korotkov method as a standard method, and a CardioQVARK® device, made in the form of a smartphone case, was used as a new method. The device records the electrocardiogram and the photoplethysmogram. Based on the parameters of the electrocardiogram and the photoplethysmogram the systolic and diastolic blood pressure (SBP and DBP) is calculated. Correlation analysis, Student’s t-test, Bland-Altman method were used for comparing the two methods, the standard deviation of the difference and a 95% confidence interval (95% CI) were calculated.Results. There were no statistically significant differences in the mean values of SBP and DBP for the two methods. There was a strong direct relationship between SBP (r = 0.976, p < 0.0001) and DBP (r = 0.817, p < 0.0001), measured by two methods. Bias for SBP and DBP measured by the new method was: –0.5 mm Hg (95% CI: –1.7; 0.7) and –0.3 mmHg (95% CI: –1.4; 0.7), respectively. The difference in DBP measurements depended on the blood pressure level (r = 0.302, p = 0.03). The underestimation of DBP values was more pronounced for low blood pressure from 55 to 75 mm Hg. At the time of the study, 13 (26%) patients had an increase in blood pressure. The sensitivity of the new method in detecting arterial hypertension was 77% (95% CI: 46; 95), specificity 100% (95% CI: 91; 100), accuracy 94% (95% CI: 83; 99).Conclusion. The blood pressure measurement method based on the analysis of the electrocardiogram and photoplethysmogram showed reliable blood pressure measurement results in comparison with the Korotkov method.

Research objective was studying of the PWV features at male patients with EH stage I-II and moderate and severe cardiovascular risk. It were surveyed 128 male patients with EH of 1-3 degrees. All patients were divided into 3 groups after stratification of risk factors for cardiovascular disease. It were investigated 2 diagnostic thresholds for detection of arterial stiffness: PWV normal level < 10 m/s and the individual threshold of PWV depending on age and hypertension grade [Arterial Stiffness' Collaboration, 2010], which was the normal (in the range of 10th percentile – median) and high normal PWV (above median). Results. PWV level in IA group was 7,15 (6,38; 7,70) m/s, PWV high level frequency registered in 11 (50%) patients according to age and blood pressure level. In IB group PWV value was 8,10 (7,23; 8,53) m/s, PWV high level frequency registered in 17 (77,3%) patients according to age and blood pressure level. In II group PWV value was 9,85 (8,5; 10,9) m/s and in 42 patients (50%) PWV level increased more than 10 m/s, that was testified to the target organ damage. In 22 male patients from the II group (26,20%) was individual increasing of PWV according to age and blood pressure level. Conclusions. The detected signs of arterial wall stiffness in patients with early stage of EH indicate increasing of cardiovascular risk severity and necessary for timely evaluation of pulse wave velocity for the early identifying of premature vascular aging.

The article shows the historical background to the emergence and subsequent development of combined antihypertensive therapy from creation of a multi-component drug to modern fixed combinations as the most effective approach in the treatment of hypertension (HTN). The authors consider that Russian scientist therapist academician of the USSR Academy of medical Sciences A. L. Myasnikov, has priority in the development of fixed drug combination concept, created depressin powder. The development of pharmacology as a science and the achievements in pharmaceutical technologies contributed to the expansion of possible drugs combination for HTN treatment, and the discovery of new diverse pathophysiological mechanisms implemented in this pathology led to the understanding of the need for combined drugs in clinical practice. The advantages of combination HTN therapy versus monotherapy include rapid achievement of the target blood pressure level, low frequency of tachyphylaxis, longer-lasting antihypertensive effect, no need to change drugs, higher compliance, effective organoprotection and cardiovascular risk reduction, positive and/or neutral effects on the main parameters of metabolism, reduced frequency and severity of side effects. Taking into account these facts, as well as the wide prevalence of HTN in the population, its high medical and social significance, the key role in atherosclerosis, it is necessary to develop new combined domestic drugs for the treatment of HTN and their inclusion in the list of vital medicines, increasing the availability of these drugs for the population on the basis of preferential programs.

A total of 91 people including 47 in the intervention group and 44 in the placebo group were included to a randomized controlled study. It can be asserted that acupressure, applied to the Neiguan (PC 6) acupuncture point in individuals with essential hypertension, provides blood pressure regulation and is effective for management of numerous hypertension-related symptoms.

Purpose: To evaluate the achievement of target blood pressure (BP) level in patients with coronary heart disease and hypertension who were under follow-up of cardiologists of the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department Materials and methods: We evaluated 1120 electronic medical records (medical software program “ESCUL’ap”) and carried out an analysis of target BP level’s achievement in 512 patients with coronary heart disease and hypertension who were under follow-up of cardiologists of the Therapeutic department of our institution and were reviewed by a cardiologist in 2019. The percentage of female patients was 30,1±2,0%. Patient`s age ranged from 37 to 91 years, the mean age was 72,1±0,4 years, 72,8±0,6 years in woman and 71,8±0,4 years in mans. We used statistical software programs (Statistica v. 6.0) and Microsoft Excel 2007 applications for data analysis. Categorical data were presented as absolute and relative (%) frequency. To enable comparisons, we calculated the mean value (M), and the the standard error of the mean (m). Student's t-test was used to compare the mean of data for groups. Results and discussion: According to data of the medical records the target level of BP (0,05). The highest rate of target BP achievement – 83,3±6,8% – was in 50-59 years old, the lowest – 61,5±3,2% – in 70-79 years old. Our results were significantly better than in the EUROASPIRE IV survey – according to the results of this study the target BP levels were achieved only by 38% of men and 47% of women in Ukraine and by 35% of men and 48% of women in other European countries. Conclusions. Our study demonstrates that 67,0±2,1% (70,1±2,4% of mans and 59,7±4,0% of women) of patients with coronary heart disease and hypertension who were under follow-up of cardiologists achieved the target level of BP (

Health is the level of functional or metabolic efficiency of a living organism. In humans, it is the ability of individuals or communities to adopt and self-managed, when facing physical mental or social changes. Hypertension is called as the "Silent Killer" because it is a disease that usually occurs without any symptoms. Lemon juice is also an excellent source of Arginine, the essential Amino acids that help lowering blood pressure. The present study aims to assess the effectiveness of Daily intake of lemon juice along with walking decrease the level of blood pressure among hypertensive clients between 40-70years. A quantitative quasi-experimental research design was conducted among 30 hypertensive clients who were selected by using non-probability convenience sampling technique. A structured interview was used to collect demographic data and hypertension was assessed by observational checklist. Pre-test was conducted before administering the lemon juice by observing the blood pressure level using Observed Checklist method among the hypertensive clients. The time for assessment varied from 15 - 20 minutes. The Lemon juice of 250ml was administered along with walking to the samples and immediately after 1 hour, post-test was conducted by observation checklist. The study finding clearly infers that there was a significant reduction in the level of hypertension in the post-test which clearly infers that intake of lemon juice along with walking proves to be effective in reducing the level of hypertension and improves the quality of life of the hypertensive clients.

Background Many systematic reviews and meta-analyses have assessed the efficacy of dietary patterns on blood pressure (BP) lowering but their findings are largely conflicting. Objective This umbrella review aims to provide an update on the available evidence for the efficacy of different dietary patterns on BP lowering. Methods PubMed and Scopus databases were searched to identify relevant studies through to June 2020. Systematic reviews with meta-analyses of randomized controlled trials (RCTs) were eligible if they measured the effect of dietary patterns on systolic (SBP) and/or diastolic blood pressure (DBP) levels. The methodological quality of included systematic reviews was assessed by A Measurement Tool to Assess Systematic Review version 2. The efficacy of each dietary pattern was summarized qualitatively. The confidence of the effect estimates for each dietary pattern was graded using the NutriGrade scoring system. Results Fifty systematic reviews and meta-analyses of RCTs were eligible for review. Twelve dietary patterns namely the Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Nordic, vegetarian, low-salt, low-carbohydrate, low-fat, high-protein, low glycemic index, portfolio, pulse, and Paleolithic diets were included in this umbrella review. Among these dietary patterns, the DASH diet was associated with the greatest overall reduction in BP with unstandardized mean differences ranging from -3.20 to -7.62 mmHg for SBP and from -2.50 to -4.22 mmHg for DBP. Adherence to Nordic, portfolio, and low-salt diets also significantly decreased SBP and DBP levels. In contrast, evidence for the efficacy of BP lowering using the Mediterranean, vegetarian, Paleolithic, low-carbohydrate, low glycemic index, high-protein, and low-fat diets was inconsistent. Conclusion Adherence to the DASH, Nordic, and portfolio diets effectively reduced BP. Low-salt diets significantly decreased BP levels in normotensive Afro-Caribbean people and in hypertensive patients of all ethnic origins. This review was registered at PROSPERO as CRD42018104733.

Hypertension is the most medical problem encountered in pregnancy to postpartum period and remains one of the most causes of maternal death. High nitrate content of beetroot as well as potassium and flavonoids of celery may lower blood pressure. This study investigate the effectiveness of beetroot extracts on reducing blood pressure postpartum mothers with hypertension. The study was a Quasy-experimental control group pre-posttest design. A total sample of 30 postpartum mothers with hypertention was enrolled in the study and randomly assigned in 2 groups. The consumption of beetroot extract decreased systolic BP 27,40 and diastolic 13,47. Meanwhile in CG, BP was reduced by 8,40 for systolic and 10,53 for diastolic. There was a difference in mean decrease systolic BP between the intervention and control group (p0.05). Beetroot extract effective reducing blood pressure postpartum mother with hypertension without worrying about side effects.

Objective Limited data exist to inform blood pressure (BP) thresholds for patients with atrial fibrillation prescribed direct oral anticoagulants (DOAC) therapy in the real world setting. Methods SBP was measured in 9051 primary care patients in England on DOACs for atrial fibrillation with postinitiation BP levels available within the Clinical Practice Research Datalink. The incidence rate for the primary outcome of the first recorded event (defined as a diagnosis of first stroke, recurrent stroke, myocardial infarction, symptomatic intracranial bleed, or significant gastrointestinal bleed) and of secondary outcomes all-cause mortality and cardiovascular mortality were calculated by postinitiation BP groups. Results The Cox proportional hazard ratio of an event [crude and adjusted hazard ratio 1.04 (95% confidence interval (CI) 1.00-1.08), P = 0.077 and 0.071, respectively] did not differ significantly with a 10 mmHg increase in SBP. The hazard of all-cause mortality [crude hazard ratio 0.83 (95% CI 0.80-0.86), P = 0.000; adjusted hazard ratio 0.84 (95% CI 0.81-0.87), P = 0.000] and cardiovascular mortality [crude hazard ratio 0.92 (95% CI 0.85-0.99), P = 0.021; adjusted hazard ratio 0.93 (95% CI 0.86-1.00), P = 0.041] demonstrated a significant inverse relationship with a 10 mmHg increase in SBP. Patients with a SBP within 161-210 mmHg had the lowest all-cause death rate, while patients with SBP within 121-140 mmHg had the lowest cardiovascular death rate. Conclusion SBP values below 161 mmHg are associated higher all-cause mortality, but lower event risk in patients with atrial fibrillation on DOAC therapy. The nadir SBP for lowest event rate was 120 mmHg, for lowest cardiovascular mortality was 130 mmHg and for lowest all-cause mortality was 160 mmHg. This demonstrates a need for a prospective interventional study of BP control after initiation of anticoagulation.

The new Chinese hypertension guideline comprehensively covers almost all major aspects in the management of hypertension. In this new guideline, hypertension remains defined as a systolic/diastolic blood pressure of at least 140/90 mm Hg. For risk assessment, a qualitative approach is used similarly as in previous Chinese guidelines according to the blood pressure level and the presence or absence of other risk factors, target organ damage, cardiovascular complications, and comorbid diseases. The therapeutic target is 140/90 mm Hg in general, and if tolerated, especially in high‐risk patients, can be more stringent, that is, 130/80 mm Hg. However, a less stringent target, that is, 150/90 mm Hg, is used in the younger (65‐79 years, if tolerated, 140/90 mm Hg) and older elderly (≥80 years). Five classes of antihypertensive drugs, including β‐blockers, can be used either in initial monotherapy or combination. The guideline also provided information on the management of hypertension in several special groups of patients and in the presence of secondary causes of hypertension. To implement the guideline recommendations, several nationwide hypertension control initiatives are being undertaken with new technology. The new technological platforms hopefully will help improve the management of hypertension and generate scientific evidence for future hypertension guidelines, including a possible Asian hypertension guideline in the near future.

PURPOSE A community program is an efficient model for improving the management of chronic diseases such as hypertension, diabetes, and dyslipidemia. A specific blood pressure (BP) measurement protocol was developed for community settings in which BP was measured by the interviewer at the interviewee's home. MATERIALS AND METHODS In the 2018 Korean Community Health Survey, BP was measured twice at a five-minute interval after a five-minute resting period at the beginning of the survey. In 2019, BP was measured at the end of the survey after a two-minute rest and was obtained as three measurements at one-minute intervals. As factors related to BP level, stressful stimuli within 30 min before BP measurement such as smoking, caffeine, and/or exercise; duration of rest; and survey year were analysed. RESULTS The mean age of participants was 55.2 years, and females accounted for 55.4% of the participants (n = 399,838). Stressful stimuli were observed in 21.9% of the participants in 2018 (n = 188,440) and 11.3% in 2019 (n = 211,398). Duration of rest was 0 min (2.1%), two minutes (55.0%), and five minutes (47.9%). When adjusted for age, sex, body mass index, antihypertensive medication, the arm of measurement, survey year (beta= -4.092), stressful stimuli (beta = 0.834), and resting time (beta = -1.296 per one minute of rest) were significant factors for mean systolic BP. A two-minute rest was not a significant factor in mean BP. The differences in adjusted mean systolic BPs were significant for rest times of five minutes vs. two minutes (3.1 mmHg, p