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Cureus May 2024Hypertension (HTN), a leading risk factor for cardiovascular diseases, is intricately linked with endothelial dysfunction, a hallmark of vascular pathology. The effect...
INTRODUCTION
Hypertension (HTN), a leading risk factor for cardiovascular diseases, is intricately linked with endothelial dysfunction, a hallmark of vascular pathology. The effect of oxidative stress in maintaining the optimum endothelial function in the regulation of blood pressure is yet to be explored. While numerous factors contribute to the pathogenesis of HTN, emerging evidence highlights the pivotal role of oxidative stress in endothelial dysfunction, offering novel insights into the underlying mechanisms.
AIM
Our study delves into the multifaceted relationship between oxidative stress and endothelial dysfunction in HTN, elucidating key molecular pathways and potential therapeutic avenues. Our study aims to find out the association between oxidative stress and endothelial function in the regulation of blood pressure.
METHODS
A total of 108 age-matched participants of both genders were divided into three groups by following the guidelines of the American Heart Association (AHA) classification for HTN. Blood pressure was recorded manually in resting posture three times at an interval of 10 minutes using a sphygmomanometer after providing 10 minutes of rest before the first reading. Parameters of oxidative stress and endothelial function were measured by using a UV spectrophotometer. Our study results were depicted as mean ± SD.
RESULTS
The correlation between our variables was performed using Spearman's correlation considering the value of p<0.05 as statistically significant. Serum malondialdehyde (MDA), a parameter of oxidative stress, was found to be increasing and serum nitric oxide (NO), a parameter to assess endothelial function, was found to be decreasing as the blood pressure increased. These observations are indicative that optimal oxidative stress and optimal endothelial function are required to maintain normal blood pressure regardless of gender.
CONCLUSIONS
All persons who are suspected of future cardiovascular risks should be regularly checked for these parameters to avoid cardiovascular morbidity such as HTN.
PubMed: 38939274
DOI: 10.7759/cureus.61245 -
Journal of Cardiovascular Development... Jun 2024To assess the acute effect of empagliflozin versus dapagliflozin administration on flow-mediated vasodilation in patients with type 2 diabetes mellitus.
AIM
To assess the acute effect of empagliflozin versus dapagliflozin administration on flow-mediated vasodilation in patients with type 2 diabetes mellitus.
DESIGN
A double-blind clinical trial, at the Experimental and Clinical Therapeutics Institute, University Health Sciences Center, at the Universidad de Guadalajara, in inpatients with T2D according to the 2023 ADA criteria.
METHODS
Thirty patients (15 males and 15 females), aged between 35 and 65 years, were included in this study, according to the 2023 ADA criteria. The eligible patients were randomly assigned to three groups: empagliflozin 25 mg once daily, dapagliflozin 10 mg once daily, or placebo once daily. Anthropometric parameters were taken using validated techniques. FMD was measured using a high-resolution semiautomatic ultrasound UNEX-EF 38G (UNEX Co., Ltd., Nagoya, Japan). Arterial tension was determined with the OMRON electronic digital sphygmomanometer (HEM 907 XL, Kyoto, Japan).
RESULTS
The group of patients who received empagliflozin had a significantly lower baseline flow-mediated dilation (FMD) compared to the group receiving dapagliflozin ( = 0.017); at the end of this study, the empagliflozin group achieved a comparable FMD to the dapagliflozin group ( = 0.88).
CONCLUSION
After the treatment period, the empagliflozin and dapagliflozin groups achieved similar FMD, suggesting a class effect.
PubMed: 38921682
DOI: 10.3390/jcdd11060182 -
Environmental Health Insights 2024Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been... (Review)
Review
BACKGROUND
Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been identified as "breeding grounds" for pathogens that cause nosocomial infections. This systematic review aimed to deliver incisive insights on nosocomial pathogens in intensive care units (ICUs) and the role of fomites as potential reservoirs for their transmission.
METHOD
An extensive exploration of electronic databases, including PubMed and Scopus, from 1990 to 2023, was carried out between 25 and 29 May 2023, per standard PRISMA guidelines. Information were extracted from articles that reported on fomites in the ICU. Studies that did not quantitatively report the fomite contamination, and those that exclusively took samples from patients in the ICU were excluded from the analysis.
RESULTS
About 40% of the total samples collected on fomites from all the studies yielded microbial growth, with species of being the most predominant. Other prevalent microbes were , , , spp., sp., and sp. The neonatal intensive care unit (NICU) had the highest proportion of contaminated fomites. Among known fomites, the sphygmomanometer exhibited a 100% detection rate of nosocomial pathogens. This included , , coagulase-negative (CoNS), , and Multidrug-resistant (MDR) bacteria, such as methicillin-resistant (MRSA), vancomycin-resistant (VRE), extended-spectrum beta-lactamase (ESBL)-producing , and MDR were commonly isolated on fomites in the ICUs.
CONCLUSION
Many fomites that are readily used in patient care in the ICU harbour nosocomial pathogens. The most common fomite appeared to be mobile phones, sphygmomanometers, and stethoscopes, with being the most common contaminant. Consequently, the need for rigorous disinfection and sterilization protocols on fomites in the ICU cannot be overemphasized. Additionally, heightened awareness on the subject among health professionals is crucial to mitigating the risk and burden of nosocomial infections caused by drug-resistant bacteria.
PubMed: 38828046
DOI: 10.1177/11786302241243239 -
The Nigerian Postgraduate Medical... Apr 2024The objective of this study was to determine the blood pressure (BP) pattern and prevalence of hypertension amongst apparently healthy primary school pupils in Abuja.
OBJECTIVES
The objective of this study was to determine the blood pressure (BP) pattern and prevalence of hypertension amongst apparently healthy primary school pupils in Abuja.
METHODOLOGY
This was a descriptive, cross-sectional study carried out on apparently healthy primary school children aged 6-12 years. BP was measured using a standard mercury sphygmomanometer according to standard guidelines. Data were analysed using SPSS version 17.0. Pearson's correlation coefficient (r) and analysis of variance were used to determine the relationship between BP and various variables where applicable. P = 0.05 was considered statistically significant.
RESULTS
Out of 1011 pupils recruited for the study, 457 (42.2%) were male. The mean systolic and diastolic BP (SBP and DBP) increased significantly with age from 94.5 mmHg to 101.0 mmHg and from 61.5 mmHg to 65.3 mmHg from 6 to 12 years for SBP and DBP, respectively (P < 0.05). The prevalence of high BP was 9.1%. Age was the only predictor of SBP (β = -0.629, 95% confidence interval [CI] -1.115, -0.142), while age, height and body mass index (BMI) were the predictors of DBP (β = -0.686, 95% CI of -1.152, -0.221; β = 0.490, 95% CI of 0.172, 0.809; β = 1.753, 95% CI of 0.374, 3.160) for age, height and BMI, respectively, at P < 0.05.
CONCLUSION
The predictors of SBP and DBP as shown in this study support the recommendations by various reports for taking body size into consideration in developing reference values for various populations. Age and body size are important determinants of BP in children. Its measurement should be encouraged in schools.
Topics: Humans; Male; Child; Nigeria; Cross-Sectional Studies; Female; Prevalence; Hypertension; Blood Pressure; Body Mass Index; Schools; Blood Pressure Determination; Students; Age Factors
PubMed: 38826014
DOI: 10.4103/npmj.npmj_254_23 -
BMC Geriatrics May 2024Evidence of the optimal blood pressure (BP) target for older adults with disability in long-term care is limited. We aim to analyze the associations of BP with mortality...
BACKGROUND
Evidence of the optimal blood pressure (BP) target for older adults with disability in long-term care is limited. We aim to analyze the associations of BP with mortality in older adults in long-term care setting with different levels of disability.
METHODS
This prospective cohort study was based on the government-led long-term care programme in Chengdu, China, including 41,004 consecutive disabled adults aged ≥ 60 years. BP was measured during the baseline survey by trained medical personnel using electronic sphygmomanometers. Disability profile was assessed using the Barthel index. The association between blood pressure and mortality was analyzed with doubly robust estimation, which combined exposure model by inverse probability weighting and outcome model fitted with Cox regression. The non-linearity was examined by restricted cubic spline. The primary endpoint was all-cause mortality, and the secondary endpoints were cardiovascular and non-cardiovascular mortality.
RESULTS
The associations between systolic blood pressure (SBP) and all-cause mortality were close to a U-shaped curve in mild-moderate disability group (Barthel index ≥ 40), and a reversed J-shaped in severe disability group (Barthel index < 40). In mild-moderate disability group, SBP < 135 mmHg was associated with elevated all-cause mortality risks (HR 1.21, 95% CI, 1.10-1.33), compared to SBP between 135 and 150 mmHg. In severe disability group, SBP < 150 mmHg increased all-cause mortality risks (HR 1.21, 95% CI, 1.16-1.27), compared to SBP between 150 and 170 mmHg. The associations were robust in subgroup analyses in terms of age, gender, cardiovascular comorbidity and antihypertensive treatment. Diastolic blood pressure (DBP) < 67 mmHg (HR 1.29, 95% CI, 1.18-1.42) in mild-moderate disability group and < 79 mmHg (HR 1.15, 95% CI, 1.11-1.20) in severe disability group both demonstrated an increased all-cause mortality risk.
CONCLUSION
The optimal SBP range was found to be higher in older individuals in long-term care with severe disability (150-170mmHg) compared to those with mild to moderate disability (135-150mmHg). This study provides new evidence that antihypertensive treatment should be administered cautiously in severe disability group in long-term care setting. Additionally, assessment of disability using the Barthel index can serve as a valuable tool in customizing the optimal BP management strategy.
TRIAL REGISTRATION
Chinese Clinical Trial Registry (Registration Number: ChiCTR2100049973).
Topics: Humans; Male; Female; Aged; China; Prospective Studies; Disabled Persons; Long-Term Care; Blood Pressure; Middle Aged; Aged, 80 and over; Cohort Studies; Hypertension; Mortality; East Asian People
PubMed: 38822230
DOI: 10.1186/s12877-024-05094-y -
Cureus Apr 2024Introduction Proximal femoral fractures are common fractures of the hip that are considered a major healthcare concern globally; these include subtrochanteric,...
Introduction Proximal femoral fractures are common fractures of the hip that are considered a major healthcare concern globally; these include subtrochanteric, intertrochanteric, and the neck of the femur fractures. Internal fixation surgery and joint replacement surgery are the two most common intervention techniques used to treat these fractures. Consequently, weakness in the hip abductor muscle post-surgery may lead to implant loosening, necessitating revision of the surgery. In light of this, this study aimed to compare hip abductor strength recovery outcomes between joint replacement surgery and internal fixation surgery. Methodology A comparative study was performed over six months at the Department of Orthopaedics and Physiotherapy. Based on the inclusion and exclusion criteria and anticipating potential dropouts, a total of 56 patients were included in the study, and their hip abductor strength was measured using a sphygmomanometer. The patients were classified into two groups: Group A or Group B as per the type of hip surgery. Group A included 29 patients who underwent joint replacement surgeries involving either cemented or uncemented total hip arthroplasty (THA) or hip hemiarthroplasty (HHA). Group B comprised 27 patients who were operated on using either proximal femoral nail (PFN) or dynamic hip screw (DHS). Results The cohort consisted of 36 males and 20 females, with a mean age of 51.71 years. The overall mean value of hip abductor muscle strength at postoperative day (POD) three in the internal fixation group was 65.06 ±5.98, which progressed to 107.51 ±24.76 after six months; in the joint replacement surgery group, it was 70.03 ±12.46 at POD three, which progressed to 113.11 ±21.27 after six months. The age-wise distribution demonstrated that the patients in the age group of 18-50 years demonstrated progressive results: from 65.33 ±4.9 at POD three to 105.95 ±22.71 after six months in the internal fixation group; from 66.82 ±7.72 at POD three to 109.59 ±22.54 after six months in the joint replacement group. Moreover, patients aged above 50 years showed progression from 64.80 ±6.98 at POD three to 103.33 ±27.30 after six months in the internal fixation group, and from 69.58 ±14.75 at POD three to 108.22 ±20.62 after six months in the joint replacement group. Conclusions Our findings revealed that joint replacement surgery resulted in greater improvements in the hip abductor muscle strength compared to internal fixation surgery in the immediate postoperative period and during follow-ups. Additionally, younger patients exhibited better strength-related outcomes in comparison to the elderly population regardless of the type of surgery.
PubMed: 38803789
DOI: 10.7759/cureus.59120 -
Journal of Feline Medicine and Surgery May 2024The aim of the present study was to assess the effect of gabapentin on blood pressure (BP) in cats with and without chronic kidney disease (CKD).
OBJECTIVES
The aim of the present study was to assess the effect of gabapentin on blood pressure (BP) in cats with and without chronic kidney disease (CKD).
METHODS
A randomized, blinded, placebo-controlled crossover study was performed. A total of 29 cats were included: 13 cats with stable CKD (IRIS stage 2-4) and 16 apparently healthy cats (serum creatinine <1.6 mg/dl and urine specific gravity >1.035). The cats were evaluated twice, approximately 1 week apart, and BP (Doppler sphygmomanometry) was obtained 3 h after cats received either a single dose of gabapentin 10mg/kg PO or placebo. For each cat, BP readings were obtained at each visit using the same Doppler and sphygmomanometer unit, and the same cat holder and Doppler operator, in the same location.
RESULTS
After administration of a single dose of gabapentin (10 mg/kg PO), BP was significantly lower (median 122 mmHg, range 82-170) than after administration of the placebo (median 150 mmHg, range 102-191; = 0.001). In the CKD subgroup, BP was significantly lower after administration of gabapentin (median 129 mmHg, range 96-170) than after administration of the placebo (median 155 mmHg, range 102-191; = 0.008). In the healthy cat subgroup, BP was significantly lower after administration of gabapentin (median 121 mmHg, range 82-139) than after administration of the placebo (median 137 mmHg, range 102-177; = 0.002). The median change in BP was -12 mmHg (range -95 to 10) for healthy cats and -12 mmHg (range -43 to 21) for cats with CKD (no significant difference between subgroups).
CONCLUSIONS AND RELEVANCE
Gabapentin may decrease arterial BP in cats with and without CKD and these findings should be taken into account when gabapentin is administered to patients in which measurement of BP is needed.
Topics: Animals; Cats; Gabapentin; Cat Diseases; Renal Insufficiency, Chronic; Cross-Over Studies; Blood Pressure; Male; Female
PubMed: 38770706
DOI: 10.1177/1098612X241240326 -
Korean Circulation Journal May 2024
PubMed: 38767341
DOI: 10.4070/kcj.2024.0115 -
Korean Circulation Journal May 2024Blood pressure (BP) measurement using an auscultatory sphygmomanometer is recommended for diagnosing hypertension in children. As mercury sphygmomanometers (MSs) are...
Replacing Mercury Sphygmomanometers With Mercury-Free Sphygmomanometers for the National Health Survey in Children: Direct Comparisons Applying Two Types of Mercury-Free Sphygmomanometer.
BACKGROUND AND OBJECTIVES
Blood pressure (BP) measurement using an auscultatory sphygmomanometer is recommended for diagnosing hypertension in children. As mercury sphygmomanometers (MSs) are banned owing to environmental concerns, it is crucial to determine the accuracy of mercury-free sphygmomanometers to replace them. We analyzed the accuracy of these devices to guide the National Survey selection.
METHODS
BP was measured thrice each with MS, auscultatory device (AD), and oscillometric device (OD) in 104 participants aged 10-18 using the National Survey data. The difference in BP was defined as the difference between MS and other devices. The BP differences, correlations, and influencing factors were analyzed. The frequencies of hypertension were also compared.
RESULTS
Systolic BP (SBP) and diastolic BP (DBP) differences between MS and AD were 0.88±3.36 mmHg and 0.63±3.95 mmHg, and those between MS and OD were 0.43±5.83 mmHg and 4.57±6.89 mmHg, respectively. The absolute error of <10 mmHg for DBP between MS and OD was 76%. The concordance correlation coefficient between MS and AD was 0.94 for SBP and 0.90 for DBP, and 0.81 and 0.67, respectively for MS and OD. Arm circumference negatively correlated with BP differences except for SBP between the MS and OD. The frequency of hypertension was not different between MS and AD but was underestimated by OD.
CONCLUSIONS
AD correlated well with MS, while OD did not, especially for DBP. The superiority of AD over OD suggests AD as a possible alternative for MS in the National Survey.
PubMed: 38767340
DOI: 10.4070/kcj.2023.0274 -
Environmental Health : a Global Access... May 2024To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters.
OBJECTIVES
To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters.
METHODS
We assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5 μm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes.
RESULTS
The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01).
CONCLUSION
This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.
Topics: Humans; Vascular Stiffness; Male; Female; Chicago; Middle Aged; Air Pollutants; Environmental Exposure; Aged; Particulate Matter; Air Pollution; Cross-Sectional Studies; Hemodynamics; Adult; Nitrogen Dioxide; Blood Pressure; Ethnicity; Black or African American
PubMed: 38715087
DOI: 10.1186/s12940-024-01077-z