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Proceedings (Baylor University. Medical... 2024We conducted a comprehensive systematic review to examine the efficacy of intensive blood pressure lowering on the risk of left ventricular hypertrophy (LVH).
The effect of intensive blood pressure lowering on left ventricular hypertrophy in patients with hypertension: a systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
We conducted a comprehensive systematic review to examine the efficacy of intensive blood pressure lowering on the risk of left ventricular hypertrophy (LVH).
METHODS
We searched PubMed, Scopus, Web of Science, Cochrane Central, and EMBASE for all relevant randomized controlled trials. The primary outcome was the incidence of left ventricular hypertrophy. We used the risk ratio (RR) and hazard ratio (HR) with a 95% confidence interval as our effect sizes.
RESULTS
Four studies, comprising 20,747 patients, were included. Intensive blood pressure lowering was linked with a diminished LVH incidence (RR: 0.66, 95% CI [0.56-0.77]). We also found that intensive blood pressure lowering increased the risk of LVH regression in patients with baseline LVH (RR: 1.21, 95% CI [1.11-1.32]). Finally, intensive blood pressure lowering was linked with a reduced risk of cardiovascular disease (HR: 0.71, 95% CI [0.60-0.85]). No significant heterogeneity was seen in either outcome.
CONCLUSION
Our study suggests that intensive blood pressure lowering effectively reduces the risk of LVH and cardiovascular disease. An interactive version of our analysis can be accessed here: https://databoard.shinyapps.io/lvh_hypertophy/.
PubMed: 38910799
DOI: 10.1080/08998280.2024.2346409 -
JBI Evidence Synthesis Jun 2024The objective of this review was to assess and synthesize evidence on the effectiveness and safety of self-management interventions for improving glycemic control and...
Effectiveness and safety of self-management interventions for improving glycemic control and health-related quality-of-life among adults with type 2 diabetes mellitus in sub-Saharan Africa: a systematic review and meta-analysis.
OBJECTIVE
The objective of this review was to assess and synthesize evidence on the effectiveness and safety of self-management interventions for improving glycemic control and health-related quality of life (HRQoL) among adults with type 2 diabetes mellitus (T2DM) in sub-Saharan Africa.
INTRODUCTION
There has been a rapid increase in the prevalence of T2DM in sub-Saharan Africa. Lifestyle-related risk factors require self-management strategies, and these must be tailored to the context. Several randomized controlled trials (RCTs) evaluating T2DM self-management interventions in sub-Saharan Africa have been conducted.
INCLUSION CRITERIA
This systematic review included RCTs assessing the effectiveness and safety of self-management interventions among adults with T2DM in sub-Saharan Africa, where the self-management intervention matched at least 1 category of the Practical Reviews in Self-Management Support (PRISMS) for long-term conditions taxonomy.
METHODS
The following databases were searched from inception until January 14, 2023: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Directory of Open Access Journals, EthOS, and ProQuest Dissertations and Theses (ProQuest). Global Health (EBSCOhost) was searched from inception until June 8, 2021. OpenGrey was searched from inception until its archive date of December 1, 2020. Two independent reviewers conducted title and abstract screening, full-text screening, data extraction, and critical appraisal. Disagreements were resolved through discussion or with a third reviewer. Data synthesis was conducted narratively, followed by meta-analysis where feasible. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach for assessing the certainty of evidence was applied.
RESULTS
From 2699 records identified, 18 RCTs were included in the systematic review and 14 in the meta-analysis. Interventions included broad self-management education programs, peer support, exercise interventions with education, nutrition education, educational text messaging, and blood glucose self-monitoring support. Only 4 studies were assigned a "yes" result for more than half of the criteria in the standardized JBI critical appraisal tool for RCTs. Compared to the control, self-management interventions did not significantly reduce glycated hemoglobin (HbA1c) at 3 months (302 participants, mean difference [MD] -6.0 mmol/mol, 95% CI -17.5, 5.4; very low certainty on GRADE assessment) or 12 months (1504 participants, MD -3.7 mmol/mol, 95% CI -8.2, 0.7; moderate certainty on GRADE assessment). HbA1c was significantly reduced at 6 months (671 participants, MD -8.1 mmol/mol, 95% CI -10.7, -5.4; low certainty on GRADE assessment). Four studies assessed HRQoL, but only 1 demonstrated an improvement (2205 participants). Three studies reported no adverse events in relation to the trial interventions (1217 participants), and it was not reported in the remainder. There did not appear to be clinically significant effects on body mass index, lipid profile, and systolic or diastolic blood pressure. The evidence was mixed for weight and waist circumference.
CONCLUSIONS
Self-management interventions for adults living with T2DM in sub-Saharan Africa may produce a clinically significant improvement in glycemic control at 6 months, but this may wane in the longer-term. There was not convincing evidence to indicate a benefit of these interventions on HRQoL, but reporting on this outcome measure was limited. There were insufficient data on adverse events to be able to draw conclusions.
REVIEW REGISTRATION
PROSPERO CRD42021237506.
PubMed: 38910533
DOI: 10.11124/JBIES-23-00273 -
Current Cardiology Reviews Jun 2024Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD...
BACKGROUND
Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD in the DSM-5 has underscored the importance of comprehensively understanding its physiological and psychological effects.
OBJECTIVE
This systematic review aims to analyze and synthesize existing literature on the cardiophysiological and neurophysiological activities of individuals diagnosed with IGD, with a focus on identifying patterns, trends, and implications for clinical practice and future research.
METHODS
A systematic search was conducted in PubMed and Scopus databases to identify relevant studies published up to 2023. The search strategy included terms related to IGD, cardiophysiology, neurophysiology, and relevant measurement techniques. Inclusion criteria encompassed peer-reviewed research articles and clinical trials examining cardiophysiological (e.g., heart rate variability, blood pressure) and neurophysiological (e.g., brain imaging, electroencephalography) parameters in individuals with IGD. Exclusion criteria were applied to ensure methodological rigor and relevance to the research question.
RESULTS
The initial search yielded 1320 papers related to IGD, of which twenty studies met the eligibility criteria and were included in the review. Data extraction and synthesis focused on key cardiophysiological and neurophysiological outcomes observed in individuals with IGD compared to healthy controls. Findings revealed decreased Heart Rate Variability (HRV), increased sympathetic activity, and executive control deficits in IGD individuals based on Electrocardiogram (ECG) recordings and cognitive assessments. Neuroimaging studies demonstrated heightened brain activation in the lateral and prefrontal cortex, altered reward processing, and impulse control mechanisms among IGD subjects. Gender-specific differences were noted, with males exhibiting distinct thalamic activation striatum and decreased Regional Homogeneity (ReHo) in the right Posterior Cingulate (rPCC) compared to females.
DISCUSSION
The synthesized evidence indicates a complex interplay between excessive gaming and cardiophysiological/neurophysiological changes, highlighting the need for multidimensional assessments in diagnosing and managing IGD. Implications for clinical practice include early detection using ECG, EEG, and advanced neuroimaging techniques, as well as personalized interventions tailored to individual characteristics and gender-specific differences.
CONCLUSION
This systematic review provides a comprehensive overview of the cardiophysiological and neurophysiological activities associated with Internet Gaming Disorder. The findings underscore the need for further research to elucidate underlying mechanisms, develop standardized diagnostic protocols, and optimize targeted interventions for individuals with IGD.
PubMed: 38910426
DOI: 10.2174/011573403X295560240530104352 -
Primary Care Diabetes Jun 2024To evaluate the glycated hemoglobin (HbA1c), blood pressure, self-efficacy, and quality of life efficacy of using telecare services for community-dwelling people with... (Review)
Review
OBJECTIVE
To evaluate the glycated hemoglobin (HbA1c), blood pressure, self-efficacy, and quality of life efficacy of using telecare services for community-dwelling people with diabetes.
METHODS
Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus databases were systematically searched from their inception dates to June 22, 2023. Two evaluators independently selected and evaluated eligible studies. A protocol was registered in PROSPERO.
RESULTS
An analysis of 17 studies that included 3586 subjects showed that telecare significantly improved the management of patients with diabetes. Compared to controls, intervention care had significant benefits regarding HbA1c (MD = -0.30, 95 % CI = -0.44 - -0.17, 16 studies), systolic blood pressure (MD = -2.45, 95 % CI = -4.53 - -0.36, P = 0.02), self-efficacy (MD = 0.36, 95 % CI = 0.04 - 0.67, P = 0.03) and quality of life (MD = 0.37, 95 % CI = 0.05 - 0.70, P = 0.02). However, diastolic blood pressure (MD = -1.37, 95 % CI = -3.34 - -0.61, P = 0.17) was not found to be significantly affected.
CONCLUSIONS
Telecare is effective in improving self-management among community-dwelling people with diabetes, suggesting an effective means for them to achieve self-management.
PubMed: 38910036
DOI: 10.1016/j.pcd.2024.06.008 -
Frontiers in Pharmacology 2024[This corrects the article DOI: 10.3389/fphar.2023.1156655.].
[This corrects the article DOI: 10.3389/fphar.2023.1156655.].
PubMed: 38903988
DOI: 10.3389/fphar.2024.1426608 -
Frontiers in Cardiovascular Medicine 2024This study aimed to evaluate the effectiveness and safety of Allisartan Isoproxil in the management of hypertension.
OBJECTIVE
This study aimed to evaluate the effectiveness and safety of Allisartan Isoproxil in the management of hypertension.
METHODS
A comprehensive search was conducted across both English and Chinese databases, including the Cochrane Library, Embase, PubMed, Web of Science, Chinese Journal Full Text Database (CNKI), Wanfang Digital Periodical Full Text Database, and VIP Chinese Periodical Database (VIP), up to March 24, 2024. Randomized controlled trials (RCTs) investigating alisartan axetil for hypertension management were selected. Literature quality was assessed, and data were extracted for meta-analysis using Stata 15.1 software. The quality of evidence for outcome indicators was evaluated using the GRADE system level.
RESULTS
Six RCTs involving 767 participants were included. Meta-analysis revealed that, compared to placebo, the Allisartan Isoproxil group exhibited a significant reduction in systolic blood pressure (SBP) [WMD = -8.08, 95% CI (-11.81, 4.10), = 0.000] and brachial-ankle pulse wave velocity (baPWV) [SMD = -0.69, 95% CI (-1.17, 0.20), = 0.006]. However, the reduction in diastolic blood pressure (DBP) was not statistically significant [WMD = -5.48, 95% CI (-11.07, 0.10), = 0.054]. Additionally, compared to calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB), Allisartan Isoproxil did not significantly affect SBP [WMD = 0.20, 95% CI (-3.71, 4.10), = 0.921] or DBP [WMD = 0.16, 95% CI (-2.11, 2.43), = 0.891]. Allisartan Isoproxil demonstrated superior effects in increasing nitric oxide (NO) levels and decreasing endothelin (ET) levels compared to control groups [WMD = 9.56, 95% CI (6.42, 12.71), = 0.000], [WMD = -7.42, 95% CI (-11.13, -3.71), = 0.000], and showed a higher effective control rate of blood pressure [RR = 1.26, 95% CI (1.13, 1.41), = 0.000]. Subgroup analysis did not reveal significant differences. Regarding safety, there were no statistically significant differences in adverse events between the Allisartan Isoproxil group and the control groups [RR = 0.99, 95% CI (0.74, 1.32), = 0.928], and no fatal adverse events were reported.
CONCLUSION
Allisartan Isoproxil is effective in reducing SBP and baPWV, increasing NO, decreasing ET, and achieving a higher control rate of blood pressure in patients with essential hypertension. These benefits are achieved with minimal adverse reactions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023467869, identifier PROSPERO CRD42023467869.
PubMed: 38903964
DOI: 10.3389/fcvm.2024.1355014 -
The British Journal of General Practice... Jun 2024Hypertensive disorders of pregnancy (HDP) affect approximately 10-15% of pregnancies and pre-eclampsia affects 3-5% of pregnancies. Women with previous pre-eclampsia or... (Review)
Review
What interventions are effective in reducing development of hypertension and other cardiovascular complications in women who have had hypertensive disorders of pregnancy? A systematic review.
BACKGROUND
Hypertensive disorders of pregnancy (HDP) affect approximately 10-15% of pregnancies and pre-eclampsia affects 3-5% of pregnancies. Women with previous pre-eclampsia or HDP are at increased risk of hypertension (2 to 5 times) and major cardiovascular disease (1.5 to 3 times). There is little guidance on how to reduce this risk.
AIM
To establish if there are interventions in women with previous HDP or pre-eclampsia that reduce the risk of developing adverse cardiovascular outcomes.
METHOD
A protocol was submitted to PROSPERO; inclusion and exclusion criteria were determined and a search strategy implemented. Primary outcomes were: development of hypertension or change in blood pressure and development of other cardiovascular complications. Records and full texts were screened independently by two reviewers. The Cochrane Risk of Bias tool was used for quality assessment.
RESULTS
3593 articles were screened. Nine articles were included. There were seven randomised-controlled trials and two quasi-experimental studies. One study trialled antihypertensive use, two studies looked at blood pressure monitoring and six studies focused on lifestyle interventions. Three trials reported significant reductions in diastolic blood pressure in the experimental group. No studies looked at the optimal time of intervention or the impact of interventions on the development of other long-term cardiovascular complications. Five studies reported participant feedback. The majority of studies were of low quality.
CONCLUSION
Further research needs to explore potential interventions and optimal timing of interventions to reduce cardiovascular risk. Women also need to be consulted about their preferences for discussions about cardiovascular risk and potential interventions.
Topics: Humans; Female; Pregnancy; Hypertension, Pregnancy-Induced; Antihypertensive Agents; Cardiovascular Diseases; Pre-Eclampsia; Hypertension; Blood Pressure
PubMed: 38902046
DOI: 10.3399/bjgp24X738069 -
High Blood Pressure & Cardiovascular... Jun 2024The commentary on the paper entitled "The effects of ketogenic diet on systolic and diastolic blood pressure: A Systematic Review and Meta-Regression Analysis of...
Commentary on Paper Entitled "The Effects of Ketogenic Diet on Systolic and Diastolic Blood Pressure: A Systematic Review and Meta-regression Analysis of Randomized Controlled Trials".
The commentary on the paper entitled "The effects of ketogenic diet on systolic and diastolic blood pressure: A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials," provides a critical appraisal of the evidence presented and identifies key areas for further inquiry. The original paper, which compiles results from 34 high-quality studies, concludes that ketogenic diets significantly reduce systolic and diastolic blood pressures. While acknowledging these findings, the commentary highlights several issues, such as the lack of uniformity in intervention durations and the observed heterogeneity in systolic blood pressure results, suggesting that the impact of the ketogenic diet may vary significantly based on these factors. It also points out the need for clarity in discussing the term "ketogenic diets" due to the diverse protocols that exist. Moreover, the commentary enriches the discussion by proposing that future research should explore the underlying physiological mechanisms in greater depth and consider the impact of dietary composition on metabolic health and blood pressure regulation. This reflection aims to refine the conclusions drawn from the meta-analysis and suggests a more nuanced approach to studying and implementing ketogenic diets in hypertension management.
PubMed: 38900398
DOI: 10.1007/s40292-024-00657-x -
Holistic Nursing PracticeWhen it comes to end-stage renal disease patients, hemodialysing is one of the most critical treatments they can receive. Even if they received hemodialysis (HD)...
When it comes to end-stage renal disease patients, hemodialysing is one of the most critical treatments they can receive. Even if they received hemodialysis (HD) treatment regularly, patients would experience many complications such as cardiovascular disease, fatigue, anxiety, depression, sleep disturbances, and a declining quality of life. Laughter Yoga has been reported to have many positive effects on patients with chronic illnesses. By removing or reducing stress, Laughter Yoga (LY) helps to improve patients' quality of life, Thus, they have a longer chance of survival. However, the effect of Laughter Yoga on HD patients is generally inconclusive. Objective is to evaluate LY's impact on HD patients. We searched electronic databases that included Web of Science, Embase, PubMed, the Cochrane Library, Wanfang, China National Knowledge Infrastructure, and clinical trial registries. The search period was from their inception to January 29, 2023. The search keywords included laughter therapy, laughter yoga, laugh, hemodialysis, dialysis, and renal dialysis. The systematic review included both randomized controlled trials (RCTs) and quasi-experiments studies. Three RCTs and three non-RCTs met the inclusion criteria. Laughter Yoga showed patients having improvement in several outcomes such as life quality, pain severity, sleep quality, subjective well-being, mood, depression, blood pressure, and vital capacity. A well-designed RCT will be developed to further test the potential benefits of LY for HD patients.
Topics: Humans; Yoga; Renal Dialysis; Quality of Life; Kidney Failure, Chronic; Laughter Therapy; Laughter
PubMed: 38900006
DOI: 10.1097/HNP.0000000000000650 -
Journal of Clinical Medicine May 2024Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal... (Review)
Review
Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies ( = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD -0.20, 95% CI: -0.39 to -0.02) and opioid consumption (SMD -0.66, 95% CI: -0.95 to -0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD -0.91, 95% CI: -1.65 to -0.17) and remifentanil (SMD -1.52, 95% CI: -1.98 to -1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups.
PubMed: 38892833
DOI: 10.3390/jcm13113122