ObjectiveTo investigate the impact of disposable tissue on blood pressure measurement, in order to prevent the sphygmomanometer cuff to be polluted. MethodsA total of 120 subjects including 60 patients with hypertension and 60 normal blood pressure subjects, treated between July 1 and July 31, 2012, were divided equally into two groups. Each group had 30 normal pressure and 30 high pressure subjects. Subjects in group A took blood pressure measurement without disposable tissue first, 1 to 2 minutes before another measurement with disposable tissue. Group B subjects took the measurement with disposable tissue at first, and then without it. We analyzed the influence of the use of disposable tissue and the sequence of tissue usage on the measurement result. ResultsNo significant difference was found in the systolic and diastolic blood pressure between measuring with and without tissue (P> 0.05). Diastolic blood pressure was not significantly influenced by the order of tissue usage (P>0.05), while systolic pressure was significantly influenced (P<0.05). Between the subjects with and without hypertension, the differences of systolic blood pressure and diastolic blood pressure measured with bare arms and disposable tissues were not statistically significant (P>0.05). ConclusionUsing disposable tissue or not does not affect blood pressure measurements whether the patient suffers from hypertension, but the order of disposable tissue usage may affect systolic blood pressure in non-hypertensive patients.
ObjectiveTo explore the nursing intervention effect on pre-hypertension. MethodsA total of 240 prehypertension patients in our community from July 2012 to January 2013 were randomly divided into observation group and control group with 120 patients in each group. No intervention was carried out for the control group. Blood pressure profile was established for the observation group and health education, exercise intervention, diet and body weight intervention measures were also given to the patients in this group. The improvement of life behavior and blood pressure control, and the awareness of hypertension health knowledge were compared between the two groups. ResultsAwareness of the disease knowledge, risk factors, complications, prevention and treatment in the observation group was significantly better than those in the control group (P<0.05). After intervention, the improvement scores of diet control, exercise increase, smoking quitting and alcohol drinking control in the observation group were significantly higher than those in the control group (P<0.05). The systolic blood pressure, diastolic blood pressure and body mass index after intervention in the observation group were significantly lower than those in the control group (P<0.05). ConclusionCommunity nursing intervention can increase the health knowledge in pre-hypertensive patients, help patients establish a good way of life and control blood pressure effectively, and reduce the incidence of hypertension.
ObjectiveTo investigate the correlation of retinal blood vessel density with blood pressure and retinal thickness in the macular region of glaucoma. MethodsA retrospective study. From March 2019 to March 2022, 100 glaucoma patients of 100 eyes (glaucoma group) and 100 healthy people of 100 eyes (control group) diagnosed in Department of Ophthalmology of Luoyang First People's Hospital were included in the study. The patients in the glaucoma group were subdivided into the early, intermediate, and late groups based on the average visual field defect value, which were 38, 32, and 30 cases, respectively. Optical coherence tomography angiography was used to scan the macular area of the examined eyes in a 3 mm×3 mm area. The software automatically divided the retina within 3 mm of the macular central concavity into 2 concentric circles centered on the macular central concavity, which were the central concave area with a diameter of 1 mm and the paracentral concave area with a diameter of 1-3 mm. The blood flow density and retinal thickness of the superficial retinal capillary plexus in the nasal, temporal, inferior, and superior quadrants of the retina within 3 mm of the macula were measured. Blood pressure was measured at the brachial artery using an electronic sphygmomanometer. Comparisons between two groups were made by independent samples t test, and comparisons between multiple groups were made by one-way analysis of variance. Correlations between retinal blood flow density and blood pressure and retinal thickness were analyzed by Spearman's correlation analysis. ResultsThe retinal blood vessel density in the central fovea, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than that in the control group, and with the aggravation of the disease, the retinal blood vessel density in the central fovea, parafoveal, inferior and superior macular areas gradually decreased; the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than those in the control group, and with the aggravation of the disease, the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas gradually decreased, the differences were statistically significant (P＜0.05). Systolic and diastolic blood pressure were higher in the glaucoma group than in the control group, and they increased gradually as the disease worsened (P＜0.05). Spearman's correlation analyses showed that in glaucoma patients, the density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas was positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure (P＜0.05). ConclusionThe density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas are positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
Blood pressure variability (BPV) refers to the fluctuations of blood pressure in a certain period of time. In recent years, BPV is becoming a predictive marker for cardiovascular events. Given the hemodynamic and internal environmental change brought by hemodialysis as well as the complex complications, hemodialysis patients always have complex BPV. Nowadays there is no consensus on an optimal standard to evaluate BPV in hemodialysis population. Metrics usually used are as follows: blood pressure change during a certain period of time, standard deviation, coefficient of variation, variation independent of mean, average real variability, weighted mean of daytime and night-time standard deviation, residual derived from generalized linear models, and residual standard deviation. Impact factors of BPV in hemodialysis patients include age, ultrafitration volume, hemodialysis frequency and time length, peripheral vascular disease, serum calcium, antihypertensive drugs and so on. Recent studies showed significant associations between both long-term and short-term BPV with prognosis of hemodialysis patients. This review focuses on the evaluation methods, the influencing factors and the impact on prognosis of BPV.
ObjectivesTo systematically review the therapeutic efficacy of vitamin B1 for adjunctive treatment in type 2 diabetes mellitus.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM were searched to collect randomized controlled trials (RCTs) on vitamin B1 for adjunctive treatment in type 2 diabetes mellitus from inception to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted by RevMan 5.3 and Stata 12.0 softwares. ResultsA total of 6 RCTs involving 346 patients were included. The results of meta-analysis showed that, compared with the control group, the vitamin B1 adjunctive group had a significant improvement in CRP (MD=–1.09, 95%CI –1.63 to –0.54, P<0.000 1). However, the fasting blood glucose (MD=–0.23, 95%CI –0.58 to 0.13,P=0.22), glycosylated hemoglobin (MD=0.13, 95%CI –0.25 to 0.52, P=0.49), 2 hours plasma glucose (MD=–0.18, 95%CI –1.03 to 0.67, P=0.68), systolic pressure (MD=2.94, 95%CI –1.31 to 7.18, P=0.18), diastolic pressure (MD=–1.60, 95%CI –4.24 to 1.05, P=0.24), triglycerides (MD=–0.12, 95%CI –0.32 to 0.09, P=0.27), total cholesterol (MD=0.21, 95%CI –0.05 to 0.46, P=0.12), high-density lipoprotein cholesterols (MD=0.03, 95%CI –0.07 to 0.12, P=0.56) and low-density lipoprotein cholesterols (MD=0.12, 95%CI –0.11 to 0.35, P=0.30) had no significant differences between both groups.ConclusionsVitamin B1 adjunctive treatment could not improve the levels of blood glucose, blood pressure and serum lipids. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo investigate the influence and management of blood pressure on intraoperative cortex somatosensory evoked potential (CSEP) in the surgery of severe scoliosis. MethodsFrom June 2009 to March 2012, CSEP monitoring during surgery of severe scoliosis were performed on 43 patients, in whom 4 had abnormal CSEP while blood pressure decline. There were 2 males and 21 females. The average age was 16.1 years. The average preoperative Cobb angle was 96.1° (88.7-107.5°). Latency and amplitude of cortical potentials were observed with the value of the latency extension more than 10% and peak amplitude reduction more than 50% defined as abnormality. The arterial blood pressure (ABP) was used to evaluate the intraoperative blood pressure. ResultThe incidence rate of bilateral CSEP wave abnormalities after blood pressure decline was 9.3% in the surgery of severe scoliosis. One case of CSEP abnormality occurred during the installing of pedicle screws; two cases during the Smith-Petersen osteotomy, and one case during the bone graft after correction. With the ABP dropping to about 92/57 mm Hg (1 mm Hg=0.133 kPa), the amplitude decreased 80% in 24-33 minutes. After the ABP increased to 113/75 mm Hg by treatment, the index was backed up normally in 5-10 minutes. There was no neurological complication after surgery. ConclusionA high incidence rate and significantly decreased amplitude of CSEP abnormality after blood pressure decline in the surgery of severe scoliosis are found. Intraoperative stable blood pressure should be maintained for patients with severe scoliosis. When the amplitude of CSEP decreases followed with blood pressure decline, blood pressure should be actively corrected by treatment, so that the CSEP may get back to normal as soon as possible.
In recent years, the prevalence of hypertension in China has gradually increased. Although the awareness rate, treatment rate and control rate of hypertensive patients in China have been significantly raised, the overall level is still lower than that of western developed countries. In order to improve the rate of family blood pressure control, real-time warning of patients’ overall blood pressure level to doctors and the implementation of doctor-side medical intervention to patients are becoming a necessary condition. At present, the maturing home blood pressure tele-monitoring (HBPT) enhances the feasibility of increasing the interaction between doctors and patients. Randomized controlled trial evidence proves that remote monitoring can improve patient compliance and improve target blood pressure control rate. This paper introduces the relevant research results of HBPT in recent years, aiming to explore the advantages of HBPT for hypertension management and the prospect of further promotion and application.
Objective To explore the relationship between obesity and the three targets including blood pressure, glucose, and lipid. Methods A total of 181 adult Tibetans who underwent physical examination between March and September 2015 at Xigaze People's Hospital were enrolled in this study. Their obesity degrees were assessed with body mass index (BMI) and waist circumference (WC) respectively. The levels of blood pressure, glucose, and lipid were compared at the different levels of BMI or WC. Results The incidence of systematic obesity and central obesity in these adults were 57.5% and 79.0%, respectively. Compared the overweight group with the normal BMI group, the systolic pressure and diastolic pressure of the former were 9.26 mm Hg (1 mm Hg=0.133 kPa) [95% confidence interval (CI) (3.46, 15.07) mm Hg, P=0.002] and 7.76 mm Hg [95%CI (3.96, 11.57) mm Hg, P<0.001] higher, respectively. Similarly, the systolic pressure and diastolic pressure of the central obesity group were 8.24 mm Hg [95%CI (1.03, 15.46) mm Hg,P=0.026] and 6.79 mm Hg [95%CI (2.03, 11.55) mm Hg, P=0.006] higher than those in the normal WC group, respectively. For the normal WC or normal BMI subjects, the detection rate of dyslipidemia reached up to 50.0% and 52.6%. Conclusions With the increase of BMI/WC values, the level of blood pressure rises. Even though WC or BMI is normal, the detection rate of dyslipidemia is high.
Objective To systematically review the impact of vitamin D supplement on blood pressure, so as to provide a basis for clinical treatment. Methods Such databases as The Cochrane Library (Issue 8, 2011), MEDLINE (1996 to August 2011), EMbase (1974 to August 2011), CBM (1989 to 2011), CNKI (1997 to August 2011) and VIP (1989 to 2011) were searched to collect the randomized controlled trials (RCTs) about the impact of vitamin D supplement on blood pressure. Two reviewers independently screened the literature according to the inclusion criteria, extracted the data and assessed the quality. Then the meta-analysis was performed using RevMan 5.0 software. Results A total of 8 studies involving 907 participants were included. The methodological quality based on the improved Jadad scales displayed that, 7 studies scored 4 to 7 and only 1 study scored less than 4. The results of meta-analysis showed that compared with the placebo groups, vitamin D supplement had no significant difference in both systolic and diastolic blood pressure. Conclusion Based on current research evidences, compared with placebo, vitamin D supplement has no marked impact on either systolic or diastolic blood pressure. Due to the lack of studies, this conclusion still needs to be proved by conducting more well designed, large sample, and multicenter RCTs.