Abstract: Blood pressure helps the physicians greatly to have a deep insight into the cardiovascular system. The determination of individual blood pressure is a standard clinical procedure considered for cardiovascular system problems. The conventional techniques to measure blood pressure (e.g. cuff method) allows a limited number of readings for a certain period (e.g. every 5-10 minutes). Additionally, these systems cause turbulence to blood flow; impeding continuous blood pressure monitoring, especially in emergency cases or critically ill persons. In this paper, the most important statistical features in the photoplethysmogram (PPG) signals were extracted to estimate the blood pressure noninvasively. PPG signals from more than 40 subjects were measured and analyzed and 12 features were extracted. The features were fed to principal component analysis (PCA) to find the most important independent features that have the highest correlation with blood pressure. The results show that the stiffness index means and standard deviation for the beat-to-beat heart rate were the most important features. A model representing both features for Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) was obtained using a statistical regression technique. Surface fitting is used to best fit the series of data and the results show that the error value in estimating the SBP is 4.95% and in estimating the DBP is 3.99%.
Abstract: Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.
Abstract: Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.
Abstract: Objectives: The main objective of this study was to examine the association between the elevated level of C-reactive protein (CRP) and incidence of hypertension before and after adjustments for age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL, and to determine whether the association differs by race. Method: Cross sectional data for participants from aged 17 years to 74 years, included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. The CRP level was classified into three categories (> 3 mg/L, between 1 mg/L and 3 mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 indicator. Hypertension is defined as either systolic blood pressure (SBP) of 140 mmHg or more and diastolic blood pressure (DBP) of 90 mmHg or more, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as 139 ≥ SBP > 120 or 89 ≥ DBP >80. Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexicans had the highest risk of incident hypertension (OR = 2.39; 95% CI, 2.21-2.58). This risk was statistically insignificant after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08), or categorized by race [American Mexican: OR= 1.58; 95% CI, 0.58-4.26, Other Hispanic: OR = 0.87; 95% CI, 0.19-4.42, Non-Hispanic white: OR = 0.90; 95% CI, 0.50-1.59, Non-Hispanic Black: OR = 0.44; 95% CI, 0.22-0.87. The same results were found for pre-hypertension, and the Non-Hispanic black segment showed the highest significant risk for Pre-Hypertension (OR = 1.60; 95% CI, 1.26-2.03). When CRP concentrations were between 1.0 and 3.0 mg/L in unadjusted models, prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. Contrary, hypertension was not independently associated with elevated CRP, and the results were the same after being grouped by race or adjustments for the possible confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables.
Abstract: Hypertension is a common condition causing cardio
and cerebrovascular complications. Portugal has one of the highest
mortality rates from stroke and a high prevalence of hypertension.
Systolic Blood Pressure (SBP) is an important risk factor for
cardiovascular events (myocardial infarction and stroke) and
premature mortality, particularly in the elderly population. The
present study aims to estimate the prevalence of hypertension in a
Portuguese population living in a coastal city and to identify some of
its determinants (namely gender, age, the body mass index and
physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal
city in the center of Portugal, between May and August of 2013 were
evaluated. Attendants who reported to have diabetes or taking
antihypertensive drugs in the 2 previous weeks were excluded from
the study. Sociodemographic factors, BMI, habits of exercise and BP
were assessed. Hypertension was defined as blood pressure ≥140/90
mmHg. The majority of the studied population was constituted by women
(75.8%), with a mean age of 54.2±1.6 years old, married or living in
civil union and that had completed secondary school or had higher
education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2.,
and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ±
9.53. In this population we found 4.3% of people with hypertension
and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure
values than women. Of all the factors considered, SBP values also
tended to be higher with age and higher BMI values.
Despite the fact that the mean values of SBP did not present values
higher than 140 mmHg we must be concerned because the studied
population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the
upcoming research about the underlying factors responsible for the
occurrence of SBP.
Abstract: Regular exercise promotes reduction in blood pressure, reduction in body weight and it also helps to increase in insulin sensitivity. Participation in physical activity should always be linked to medical screening which can reveal serious medical problems. One of them is high blood pressure. Hypertension is risk factor for one billion people worldwide and the highest prevalence is found in Africa. Another component of hypertension is that people who suffer from hypertension have no symptoms. It is estimated that reduction of 3mm Hg in Systolic Blood Pressure decreases cardiac morbidity at least 5%. The most of the guidelines suggest aerobic exercise in a prevention of cardiovascular diseases. On the other hand, it is important to emphasize the impact of resistance training. Even, it was found higher effect for reduction on the level of systolic blood pressure than aerobic exercise.
Abstract: In this paper, algorithm estimating the blood pressure
was proposed using the pulse transit time (PTT) as a more convenient
method of measuring the blood pressure. After measuring ECG and
pressure pulse, and photoplethysmography, the PTT was calculated
from the acquired signals. Thereafter, the system to indirectly measure
the systolic pressure and the diastolic pressure was composed using
the statistic method. In comparison between the blood pressure
indirectly measured by proposed algorithm estimating the blood
pressure and real blood pressure measured by conventional
sphygmomanometer, the systolic pressure indicates the mean error of
±3.24mmHg and the standard deviation of 2.53mmHg, while the
diastolic pressure indicates the satisfactory result, that is, the mean
error of ±1.80mmHg and the standard deviation of 1.39mmHg. These
results are satisfied with the regulation of ANSI/AAMI for
certification of sphygmomanometer that real measurement error value
should be within the mean error of ±5mmHg and the standard
deviation of 8mmHg. These results are suggest the possibility of
applying to portable and long time blood pressure monitoring system
hereafter.
Abstract: A analysis on the conventional the blood pressure estimation method using an oscillometric sphygmomanometer was
performed through a computer simulation using an arterial pressure-volume (APV) model. Traditionally, the maximum amplitude algorithm (MAP) was applied on the oscillation waveforms of the APV model to obtain the mean arterial pressure and the characteristic ratio. The estimation of mean arterial pressure and
characteristic ratio was significantly affected with the shape of the blood pressure waveforms and the cutoff frequency of high-pass filter
(HPL) circuitry. Experimental errors are due to these effects when estimating blood pressure. To find out an algorithm independent from
the influence of waveform shapes and parameters of HPL, the volume
oscillation of the APV model and the phase shift of the oscillation with fast fourier transform (FFT) were testified while increasing the cuff
pressure from 1 mmHg to 200 mmHg (1 mmHg per second). The phase shift between the ranges of volume oscillation was then only observed between the systolic and the diastolic blood pressures. The same results were also obtained from the simulations performed on two different the arterial blood pressure waveforms and one
hyperthermia waveform.
Abstract: En bloc assumes modeling all phases of the orthostatic test with the only one mathematical model, which allows the complex parametric view of orthostatic response. The work presents the implementation of a mathematical model for processing of the measurements of systolic, diastolic blood pressure and heart rate performed on volunteers during orthostatic test. The original assumption of model hypothesis that every postural change means only one Stressor, did not complying with the measurements of physiological circulation factor-time profiles. Results of the identification support the hypothesis that second postural change of orthostatic test causes induced Stressors, with the observation of a physiological regulation mechanism. Maximal demonstrations are on the heart rate and diastolic blood pressure-time profile, minimal are for the measurements of the systolic blood pressure. Presented study gives a new view on orthostatic test with impact on clinical practice.
Abstract: Dilated cardiomyopathy (DCM) is a severe
cardiovascular disorder characterized by progressive systolic
dysfunction due to cardiac chamber dilatation and inefficient
myocardial contractility often leading to chronic heart failure.
Recently, a genome-wide association studies (GWASs) on DCM
indicate that the ZBTB17 gene rs10927875 single nucleotide
polymorphism is associated with DCM. The aim of the study was to
identify the distribution of ZBTB17 gene rs10927875 polymorphism
in 50 Slovak patients with DCM and 80 healthy control subjects
using the Custom Taqman®SNP Genotyping assays. Risk factors
detected at baseline in each group included age, sex, body mass
index, smoking status, diabetes and blood pressure. The mean age of
patients with DCM was 52.9±6.3 years; the mean age of individuals
in control group was 50.3±8.9 years. The distribution of investigated
genotypes of rs10927875 polymorphism within ZBTB17 gene in the
cohort of Slovak patients with DCM was as follows: CC (38.8%), CT
(55.1%), TT (6.1%), in controls: CC (43.8%), CT (51.2%), TT
(5.0%). The risk allele T was more common among the patients with
dilated cardiomyopathy than in normal controls (33.7% versus
30.6%). The differences in genotype or allele frequencies of ZBTB17
gene rs10927875 polymorphism were not statistically significant
(p=0.6908; p=0.6098). The results of this study suggest that ZBTB17
gene rs10927875 polymorphism may be a risk factor for
susceptibility to DCM in Slovak patients with DCM. Studies of
numerous files and additional functional investigations are needed to
fully understand the roles of genetic associations.