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The Cochrane Database of Systematic... Jan 2010Hypertension is considered a serious health problem worldwide. Controlling and lowering blood pressure have a significant benefit to the hypertensive patients because... (Review)
Review
BACKGROUND
Hypertension is considered a serious health problem worldwide. Controlling and lowering blood pressure have a significant benefit to the hypertensive patients because hypertension is a risk factor for stroke, heart disease and cardiovascular disease. A tropical plant called Roselle, or Red Sorrel in English-speaking countries, has been used both as a thirst-quenching drink and for medical purposes.
OBJECTIVES
To explore the effect of Roselle on blood pressure in hypertensive adult patients.
SEARCH STRATEGY
The following databases were searched (Date of most recent search was September 2009): - Cochrane Database of Systematic Reviews (2nd Quarter 2009) - DARE (2nd Quarter 2009) - Ovid MEDLINE (1950 to Present with Daily Update) - EMBASE (1980 to 2009 Week 22) - AMED (1985 to May 2009) - EBSCO CINAHL - BIOSIS (1969 to 2008) - AGRICOLA (1970 to May 2009) - Food Science and Technology Abstract (1969 to 2009 June Week 1) - International Pharmaceutical Abstracts - International Bibliographic Information on Dietary Supplements - Clinical Trials.gov and Current Controlled Trials - OpenSIGLE - Hand searching of journals - ISI Web of Knowledge
SELECTION CRITERIA
We sought randomised control trials (RCTs) evaluating use of any forms of Roselle with placebo or no treatment in hypertensive patients. Change in trough and/or peak systolic and diastolic blood pressure were primary outcomes. Secondary outcomes were withdrawals due to adverse effects, change of pulse pressure and change of heart rate.
DATA COLLECTION AND ANALYSIS
Two review authors (C Ngamjarus, CN and P Pattanittum, PP) independently scanned titles and abstracts, as well as independently screened the full reports of the potentially relevant studies. At each stage, the results were compared and disagreements were solved by discussion.
MAIN RESULTS
No studies were identified that met the inclusion criteria. However, one abstract of an ongoing study is likely to meet the inclusion criteria, when completed.
AUTHORS' CONCLUSIONS
There is insufficient evidence to support the benefit of Roselle for either controlling or lowering blood pressure in patients with hypertension. Based on the information of this review, there is a clear need to develop well-designed studies to assess the efficacy of Roselle on hypertensive patients.
Topics: Adult; Antihypertensive Agents; Blood Pressure; Humans; Hypertension; Phytotherapy; Rumex
PubMed: 20091658
DOI: 10.1002/14651858.CD007894.pub2 -
Scientific Reports Nov 2023Data on the relationship between arterial pulsatile hemodynamics and aortic root geometry, using invasive hemodynamic measurement, has been scarce. Thus, this study...
Data on the relationship between arterial pulsatile hemodynamics and aortic root geometry, using invasive hemodynamic measurement, has been scarce. Thus, this study aimed to assess the relationship between invasively measured aortic pulse pressure (aPP) and the diameter of ascending aorta (AoD). We analyzed 665 subjects (64.3 ± 11.0 years; 34.6% female) who underwent elective invasive coronary angiography (ICA) for the evaluation of coronary artery disease. Transthoracic echocardiography was performed on the same day, and AoD was measured at the level of 1 cm above the sinotubular junction at the end-diastole. Body surface area (BSA)-adjusted AoD (AoD/BSA) was used for the analysis. A pig-tail catheter was used to measure aortic pressures at a level approximately 3 cm above the aortic valve just before ICA. aPP was calculated as the difference between systolic and diastolic pressures of the aorta. In multiple linear regression analyses, aPP (β = 0.259; P < 0.001) was found to be significantly correlated with AoD/BSA even after controlling for potential confounders. This correlation power was stronger than aortic systolic pressure (β = 0.189; P < 0.001) and brachial pulse pressure (β = 0.091; P = 0.018) at the same multivariable analyses. In conclusion, our study demonstrated a significant association between invasively measured aPP and AoD/BSA, providing stronger evidence for the link between central aortic pulsatile hemodynamics and aortic root geometry.
Topics: Humans; Female; Male; Arterial Pressure; Aorta, Thoracic; Aorta; Blood Pressure; Coronary Artery Disease
PubMed: 38036600
DOI: 10.1038/s41598-023-48597-1 -
Journal of Healthcare Engineering 2018Arterial pressure waves have been described in one dimension using several approaches, such as lumped (Windkessel) or distributed (using Navier-Stokes equations) models....
Arterial pressure waves have been described in one dimension using several approaches, such as lumped (Windkessel) or distributed (using Navier-Stokes equations) models. An alternative approach consists of modeling blood pressure waves using a Korteweg-de Vries (KdV) equation and representing pressure waves as combinations of solitons. This model captures many key features of wave propagation in the systemic network and, in particular, pulse pressure amplification (PPA), which is a mechanical biomarker of cardiovascular risk. The main objective of this work is to compare the propagation dynamics described by a KdV equation in a human-like arterial tree using acquired pressure waves. Furthermore, we analyzed the ability of our model to reproduce induced elastic changes in PPA due to different pathological conditions. To this end, numerical simulations were performed using acquired central pressure signals from different subject groups (young, adults, and hypertensive) as input and then comparing the output of the model with measured radial artery pressure waveforms. Pathological conditions were modeled as changes in arterial elasticity (). Numerical results showed that the model was able to propagate acquired pressure waveforms and to reproduce PPA variations as a consequence of elastic changes. Calculated elasticity for each group was in accordance with the existing literature.
Topics: Adult; Aged; Blood Pressure; Blood Pressure Determination; Female; Humans; Hypertension; Male; Middle Aged; Models, Cardiovascular; Signal Processing, Computer-Assisted; Young Adult
PubMed: 29599937
DOI: 10.1155/2018/1364185 -
Critical Care (London, England) Sep 2020Veno-arterial extracorporeal life support (VA-ECLS) results in cardiopulmonary shunting with reduced native cardiac output (NCO). Low NCO occurrence is common and... (Observational Study)
Observational Study
BACKGROUND
Veno-arterial extracorporeal life support (VA-ECLS) results in cardiopulmonary shunting with reduced native cardiac output (NCO). Low NCO occurrence is common and associated with risk of thromboembolic and pulmonary complications. Practical tools for monitoring NCO during VA-ECLS would therefore be valuable. Pulse pressure (PP) and end-tidal carbon dioxide (EtCO) are known to be related to cardiac output. We have designed a study to test whether PP and EtCO were efficient for the monitoring of NCO during VA-ECLS.
METHODS
In this prospective single-center observational study, patients who underwent a VA-ECLS for cardiogenic shock from January 2016 to October 2017 were included, provided low NCO was suspected by a PP < 20 mmHg. NCO was measured with pulmonary artery catheter or echocardiography and compared to PP and EtCO. The ability of PP and EtCO to predict NCO < 1 L/min was evaluated with receiver operating characteristics (ROC) curves.
RESULTS
Among the 106 patients treated with VA-ECLS for cardiogenic shock during the study period, 26 were studied, allowing the collection of 196 study points. PP and EtCO relationships with NCO were nonlinear and showed strong correlations for NCO < 2 L/min (r = 0.69 and r = 0.78 respectively). A PP < 15 mmHg and EtCO < 14 mmHg had good predictive values for detecting NCO < 1 L/min (area under ROC curve 0.93 [95% CI 0.89-0.96] and 0.97 [95% CI 0.94-0.99] respectively, p = 0.058).
CONCLUSIONS
PP and EtCO may offer an accurate real-time monitoring of low NCO events during VA-ECLS support. Further studies are needed to show if their utilization may help to implement therapeutic strategies in order to prevent thromboembolic and respiratory complications associated with VA-ECLS, and to improve patients' prognosis.
TRIAL REGISTRATION
NCT03323268 , July 12, 2016.
Topics: Aged; Blood Pressure; Carbon Dioxide; Cardiac Output; Extracorporeal Membrane Oxygenation; Female; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Tidal Volume
PubMed: 32962727
DOI: 10.1186/s13054-020-03280-z -
Annals of African Medicine 2020Proportional Pulse Pressure (PPP) is a significant risk indicator in heart failure. PPP is a simple, inexpensive and easily measurable clinical index. This non-invasive...
INTRODUCTION
Proportional Pulse Pressure (PPP) is a significant risk indicator in heart failure. PPP is a simple, inexpensive and easily measurable clinical index. This non-invasive test provides useful prognostic information for patients with heart failure with reduced ejection fraction (EF) particularly in those with an EF < 30% where lower proportional pulse pressure independently predicts mortality.
METHODS
A prospective observational study involving 150 patients with reduced ejection fraction was done. Detailed history, clinical examination and parameters like pulse pressure, proportional pulse pressure were evaluated and correlated with ejection fraction.
RESULTS
The mean age of the patients was 58.99 ± 11.03 years and the majority of the study participants (57.33 %) were between 45 and 65 years of age. The most common etiology of heart failure (HF) was coronary heart disease in this study (76%). Proportional Pulse pressure showed significant association with ejection fraction. The specificity for detecting heart failure was more for proportional pulse pressure and systolic blood pressure (95 % each).
CONCLUSION
Proportional Pulse Pressure may help to identify HF patients who present with low cardiac output, low ejection fraction, and worse prognosis. Our current observations reinforce the importance of clinically based skills that must not be forgotten when managing HF.
Topics: Aged; Aged, 80 and over; Blood Pressure; Cardiac Output; Female; Heart Failure; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Factors; Severity of Illness Index; Stroke Volume
PubMed: 32820731
DOI: 10.4103/aam.aam_43_19 -
Internal Medicine Journal Jan 2021Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive... (Review)
Review
Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive explanation, by linking brachial pressure with the well documented changes in the arterial pulse waveform, whose peak and nadir determine systolic, diastolic and pulse pressure in brachial arteries. Changes in humans arterial pulse wave contour from birth to old age can be readily explained on (i) growth, with increasing length of the body from birth to adolescence, and adult height maintained thereafter, and (ii) degeneration and dilation of the aorta from elastic fibre fracture throughout life, causing progressive increase in aortic pressure wave amplitude from early return of wave reflection, and summation of incident with reflected waves in systole. These changes throughout life complement arterial pulse waveform analysis and explain brachial cuff pressure values, with optimal pulse wave pattern for cardiac interaction apparent in adolescence.
Topics: Adult; Aorta; Arterial Pressure; Blood Pressure; Brachial Artery; Humans; Longevity; Systole
PubMed: 32175664
DOI: 10.1111/imj.14815 -
PloS One 2019Angiotensin II receptor blockers (ARBs) are recommended for treating patients with hypertension. However, comparative safety and efficacy of ARB use in elderly patients... (Observational Study)
Observational Study
BACKGROUND
Angiotensin II receptor blockers (ARBs) are recommended for treating patients with hypertension. However, comparative safety and efficacy of ARB use in elderly patients have not been well established. This study was designed to determine the efficacy of fimasartan, an ARB, in hypertensive elderly patients by measuring clinic and home blood pressures (BPs) and evaluating safety compared to nonelderly patients.
METHOD
In the K-MetS study, a nationwide prospective observational study of hypertensive patients on fimasartan, elderly patients (60 years and older) who were treated for 1 year with fimasartan were recruited. BP was evaluated in clinic and at home.
RESULTS
Of the 6 399 enrolled patients, 2 363 were elderly (46.9% males, mean age 67.3 ± 5.7 years). Fimasartan reduced systolic and diastolic BP (SBP and DBP) in clinic from 144.1 ± 17.3 to 127.7 ± 12.9 mmHg and from 85.1 ± 10.4 to 76.8 ± 8.4 mmHg, respectively, (all p<0.0001) in 1 year. Similar results were found in home BPs. These BP changes were consistent with those in nonelderly patients. However, pulse pressure, a better predictor of cardiovascular events in the elderly, decreased more in elderly than in nonelderly patients by -8.2 ± 0.3 in elderly and -7.0 ± 0.2 mmHg (p<0.0001), respectively, after adjustment for confounding factors. Adverse events were reported in 1.6% of elderly hypertensives, independent of dose, which was consistent with results in nonelderly patients.
CONCLUSIONS
Fimasartan resulted in better pulse pressure reduction with similar BP reduction efficacy and safety in hypertensive elderly patients compared with nonelderly patients.
Topics: Aged; Biphenyl Compounds; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Female; Follow-Up Studies; Humans; Hypertension; Male; Middle Aged; Pyrimidines; Tetrazoles
PubMed: 30964905
DOI: 10.1371/journal.pone.0214293 -
Bioscience Reports Jun 2020A genome-wide association study (GWAS) in Chinese twins was performed to explore associations between genes and pulse pressure (PP) in 2012, and detected a suggestive...
A genome-wide association study (GWAS) in Chinese twins was performed to explore associations between genes and pulse pressure (PP) in 2012, and detected a suggestive association in the phosphatase and actin regulator 1 (PHACTR1) gene on chromosome 6p24.1 (rs1223397, P=1.04e-07). The purpose of the present study was to investigate associations of PHACTR1 gene polymorphisms with PP in a Chinese population. We recruited 347 subjects with PP ≥ 65 mmHg as cases and 359 subjects with 30 ≤ PP ≤ 45 mmHg as controls. Seven single nucleotide polymorphisms (SNPs) in the PHACTR1 gene were genotyped. Logistic regression was performed to explore associations between SNPs and PP in codominant, additive, dominant, recessive and overdominant models. The Pearson's χ2 test was applied to assess the relationships of haplotypes and PP. The A allele of rs9349379 had a positive effect on high PP. Multivariate logistic regression analysis showed that rs9349379 was significantly related to high PP in codominant [AA vs GG, 2.255 (1.132-4.492)], additive [GG vs GA vs AA, 1.368 (1.049-1.783)] and recessive [AA vs GA + GG, 2.062 (1.051-4.045)] models. The positive association between rs499818 and high PP was significant in codominant [AA vs GG, 3.483 (1.044-11.613)] and recessive [AA vs GG + GA, 3.716 (1.119-12.339)] models. No significant association of haplotypes with PP was detected. There was no significant interaction between six SNPs without strong linkage. In conclusion, the present study presents that rs9349379 and rs499818 in the PHACTR1 gene were significantly associated with PP in Chinese population. Future research should be conducted to confirm them.
Topics: Aged; Asian People; Blood Pressure; Case-Control Studies; China; Female; Genetic Association Studies; Haplotypes; Humans; Male; Microfilament Proteins; Middle Aged; Phenotype; Polymorphism, Single Nucleotide
PubMed: 32420588
DOI: 10.1042/BSR20193779 -
Arquivos Brasileiros de Cardiologia May 2017High resting heart rate is considered an important factor for increasing mortality chance in adults. However, it remains unclear whether the observed associations would...
BACKGROUND:
High resting heart rate is considered an important factor for increasing mortality chance in adults. However, it remains unclear whether the observed associations would remain after adjustment for confounders in adolescents.
OBJECTIVES:
To analyze the relationship between resting heart rate, blood pressure and pulse pressure in adolescents of both sexes.
METHODS:
A cross-sectional study with 1231 adolescents (716 girls and 515 boys) aged 14-17 years. Heart rate, blood pressure and pulse pressure were evaluated using an oscillometric blood pressure device, validated for this population. Weight and height were measured with an electronic scale and a stadiometer, respectively, and waist circumference with a non-elastic tape. Multivariate analysis using linear regression investigated the relationship between resting heart rate and blood pressure and pulse pressure in boys and girls, controlling for general and abdominal obesity.
RESULTS:
Higher resting heart rate values were observed in girls (80.1 ± 11.0 beats/min) compared to boys (75.9 ± 12.7 beats/min) (p ≤ 0.001). Resting heart rate was associated with systolic blood pressure in boys (Beta = 0.15 [0.04; 0.26]) and girls (Beta = 0.24 [0.16; 0.33]), with diastolic blood pressure in boys (Beta = 0.50 [0.37; 0.64]) and girls (Beta = 0.41 [0.30; 0.53]), and with pulse pressure in boys (Beta = -0.16 [-0.27; -0.04]).
CONCLUSIONS:
This study demonstrated a relationship between elevated resting heart rate and increased systolic and diastolic blood pressure in both sexes and pulse pressure in boys even after controlling for potential confounders, such as general and abdominal obesity.
FUNDAMENTO:
A frequência cardíaca de repouso é considerada um importante fator de aumento de mortalidade em adultos. Entretanto, ainda é incerto se as associações observadas permanecem após ajuste para fatores de confusão em adolescentes.
OBJETIVOS:
Analisar a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em adolescentes dos dois sexos.
MÉTODOS:
Estudo transversal com 1231 adolescentes (716 meninas e 515 meninos, idade de 14-17 anos). Frequência cardíaca, pressão arterial e pressão de pulso foram avaliadas com esfigmomanômetro oscilométrico validado para essa população. Peso e altura foram medidos com balança eletrônica e estadiômetro, respectivamente, e a circunferência abdominal, com uma fita inextensível. Análise multivariada com regressão linear investigou a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em meninos e meninas, controlando para obesidade geral e abdominal.
RESULTADOS:
Valores maiores de frequência cardíaca de repouso foram observados em meninas (80,1 ± 11,0 bpm) em comparação a meninos (75,9 ± 12,7 bpm) (p ≤ 0,001). Frequência cardíaca de repouso associou-se com pressão arterial sistólica em meninos [Beta = 0,15 (0,04; 0,26)] e meninas [Beta = 0,24 (0,16; 0,33)], com pressão arterial diastólica em meninos [Beta = 0,50 (0,37; 0,64)] e meninas [Beta = 0,41 (0,30; 0,53)], e com pressão de pulso apenas em meninos [Beta = -0,16 (-0,27; -0,04)].
CONCLUSÕES:
Este estudo demonstrou a relação da frequência cardíaca de repouso elevada com aumento das pressões arteriais sistólica e diastólica em ambos os sexos e com pressão de pulso em meninos, mesmo após controle para potenciais fatores de confusão, como obesidade geral e abdominal.
Topics: Adolescent; Age Factors; Arterial Pressure; Blood Pressure; Body Mass Index; Brazil; Cross-Sectional Studies; Female; Heart Rate; Humans; Male; Rest; Sex Factors; Waist Circumference
PubMed: 28492739
DOI: 10.5935/abc.20170050 -
Jornal de Pediatria 2022In this study, the authors aimed to evaluate the effectiveness of the vena cava distensibility index and pulse pressure variation as dynamic parameters for estimating...
OBJECTIVE
In this study, the authors aimed to evaluate the effectiveness of the vena cava distensibility index and pulse pressure variation as dynamic parameters for estimating intravascular volume in critically ill children.
METHODS
Patients aged 1 month to 18 years, who were hospitalized in the present study's pediatric intensive care unit, were included in the study. The patients were divided into two groups according to central venous pressure: hypovolemic (< 8 mmHg) and non-hypovolemic (central venous pressure ≥ 8 mmHg) groups. In both groups, vena cava distensibility index was measured using bedside ultrasound and pulse pressure variation. Measurements were recorded and evaluated under arterial monitoring.
RESULTS
In total, 19 (47.5%) of the 40 subjects included in the study were assigned to the central venous pressure ≥ 8 mmHg group, and 21 (52.5%) to the central venous pressure < 8 mmHg group. A moderate positive correlation was found between pulse pressure variation and vena cava distensibility index (r = 0.475, p < 0.01), while there were strong negative correlations of central venous pressure with pulse pressure variation and vena cava distensibility index (r = -0.628, p < 0.001 and r = -0.760, p < 0.001, respectively). In terms of predicting hypovolemia, the predictive power for vena cava distensibility index was > 16% (sensitivity, 90.5%; specificity, 94.7%) and that for pulse pressure variation was > 14% (sensitivity, 71.4%; specificity, 89.5%).
CONCLUSION
Vena cava distensibility index has higher sensitivity and specificity than pulse pressure variation for estimating intravascular volume, along with the advantage of non-invasive bedside application.
Topics: Blood Pressure; Central Venous Pressure; Child; Critical Illness; Humans; Ultrasonography; Vena Cava, Inferior
PubMed: 34052225
DOI: 10.1016/j.jped.2021.04.005