Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.
Objectives : The aim of this study was to investigate the correlation between Cold-Heat pattern tendency and demographic traits, physical character, and vital signs in hypertensive patients taking anti-hypertensive agents. Methods : 28 hypertensive patients 30 to 69 years old were recruited. We assessed their general characteristics, physical characteristics (height, weight, waist circumference, etc.), vital signs without respiratory rate (blood pressure, pulse rate, temperature) and administered a Cold-Heat pattern questionnaire. After that, we analyzed statistical data on separate groups according to Cold-Heat characteristics or other criteria. Results : 1. Heat group patients had statistically higher scores in waist, body mass index (BMI), waist circumference and pulse rate. 2. Over weighted group patients had statistically lower scores in cold Pattern Identification. 3. Higher BMI group (above 23/25) patients had statistically significantly higher Heat scores and lower Cold scores, higher waist circumference group patients had lower Cold scores. Conclusions : From the above result in hypertensive patients taking hypertensive agents, Heat group had a obesity tendency and the inverse is also valid. Later, progressed study based on more samples and varied data will contribute to diagnosis the Cold-heat Pattern identification in hypertensive patients.
Background: Recently, measure of heart rate variability and the nonlinear "complexity" of heart rate dynamics have been used as indicators of cardiovascular health. Several investigators have demonstrated that heart rate variability decreased in aging, congestive heart failure and coronary heart disease. Because hypertensive patients showed alternation of cardiovascular homeostasis, we designed this study to evaluate the effect of anesthesia in hypertensive patients with approximate entropy (ApEn). Methods: With informed consent, eighteen normotensive patients and eighteen hypertensive patients were given no premedication. ECG data were collected from 10 minutes before induction to 15 minutes after induction. Collected ECG data were stored into computer binary files. We calculated ApEn from the collected ECG data. Results: Before induction, ApEn of hypertensive patients was significantly lower than normotensive patients(p<0.05). During induction and maintain of anesthesia, there was no difference of ApEn between two groups. During induction and maintain of anesthesia, in normotensive group, ApEn was significantly lower than that of preinduction(p<0.05). And ApEn during maintain of anesthesia was lower than that of induction(p<0.05). During maintain of anesthesia, in hypertensive group, ApEn was significantly lower than that of preinduction(p<0.05). Conclusions: Before induction, ApTn of hypertensive patients is significantly lower than normotensive patients. As anesthesia was deepened, ApEn of two groups were decreased. Because the baroreflex of hypertensive patients is already decreased, decreasing of ApEn of hypertensive patients during anesthesia is less than that of normotnesive patients.
Purpose: This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia. Methods: Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method. Results: HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum. Conclusion: The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.
The aim of this study was to investigate the interrelationship among urinary excretion dietary habit of Na, Ca intake and hormonal factors in 22 hypertensive and 30 normotensive hospitalized patients. The results were summarized as follows : 1. Urinary excretion of Na in normotensive patients was not significantly different from that of hypertensive patients, while Ca excretion(as expressed on the basis of mg of creatinine) was significantly higher in hypertensive patients. 2. Habitual dietary intake of Na, Ca in hypertensive patients were not significantly different from those of normotensive patients. 3. There were no significant differences in mean plasma renin activity, aldosterone and parathyroid hormone(PTH) level between two groups. However, systolic pressure significantly correlated with PTH(r=0.2597) and aldosterone level(r=0.24648)(P<0.05). In this study blood pressure did not show any significant relationship between urinary Na excretion and habitual dietary Na intake of Na. It is speculated that individual difference of Na sensitivity might result in heterogenous blood pressure response to dietary Na intake. Higher Ca excretion in hypertensive subjects suggested a future study on the interrelationship between Ca metabolism and aldosterone system in hypertension.
Seo, Kyung-Hee;Lee, Hye-Jin;Lim, Bu-Dol;Choi, Yun-Jung;Oh, Hyun-Mee;Yoon, Jin-Sook
Korean Journal of Community Nutrition
/
v.14
no.6
/
pp.831-845
/
2009
Hypertension and obesity are important modifiable risk factors for cardiovascular disease, the leading cause of death in Korea. Therefore, we assessed the association between dietary pattern and obesity in hypertensive patients to formulate health promotion strategies for the older population. Dietary information was collected from hypertensive patients visiting community health education and information center by using 24 hour recall method. The 2005 DRIs for Koreans was used to evaluate the dietary adequacy. When subjects were categorized by body mass index (BMI) as normal, overweight and obese, no significant difference in energy intake was found among groups. Dietary intakes of folate, and vitamin C in obese hypertensive patients were significantly lower than in normal weight patients (p < 0.05). When we compare the nutritional status by waist circumferences, dietary intakes of zinc, vitamin A, thiamin, vitamin C and folate were significantly lower in the obese group. Vegetable intake was significantly lower in the obese group according to BMI as well as waist circumference. Energy intake from carbohydrate was significantly higher in obese hypertensive patients (p < 0.05). Obese hypertensive patients had a higher risk of nutritional inadequacy compared to normal weight patients. Our results indicated the need for developing interventions that encourage greater consumption of vegetables while cutting down salt intake with wise selection of staple foods, for obese hypertensive patients.
Rehab M. Hamdy;Shaimaa A Habib;Layla A Mohamed;Ola H. Abd Elaziz
Journal of Cardiovascular Imaging
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v.30
no.4
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pp.279-289
/
2022
BACKGROUND: In many cardiovascular disorders, the contractile performance of the right ventricle (RV) is the primary determinant of prognosis. For evaluating RV volumes and function, 4 dimensional (4D)-echocardiography has become common. This research used 2D and 4D modalities to assess RV contractile performance in hypertensive patients. METHODS: A total of 150 patients with essential hypertension were enrolled in this study, along with 75 age and sex-matched volunteers. Clinical evaluation and echocardiographic examination (including M-mode, tissue Doppler imaging, and 2D speckle tracking) were conducted on all participants. RV volumes, 4D-ejection fraction (EF), 4D-fractional area change (FAC), 4D-tricuspid annular plane systolic excursion (TAPSE), 4D-septal and free wall (FW) strain were all measured using 4D-echocardiography. RESULTS: Hypertensive patients showed 2D-RV systolic and diastolic dysfunction (including TAPSE, 2D-right ventricular global longitudinal strain, RV-myocardial performance index and average E/EaRV) and 4D-RV impairment (including right ventricular EF, FAC, RV strain and TAPSE, right ventricular end-diastolic volume and right ventricular end-systolic volume) compared to the control group. We verified the prevalence of RV systolic dysfunction in hypertension patients using the following parameters: 1) 15% of them had 2D-TAPSE < 17 mm vs. 40% by 4D-TAPSE; 2) 25% of them had 2D-GLS < 19% vs. 42% by 4D-septal strain and 35% by 4D FW strain; 3) 35% of hypertensive patients had 4D-EF < 45%; and finally; 4) 25% of hypertensive patients had 2D-FAC < 35% compared to 45% by 4D-FAC. CONCLUSIONS: The incidence of RV involvement was greater in 4D than in 2D-modality trans-thoracic echocardiography. We speculated that 4D-echocardiography with 4D-strain imaging would be more beneficial for examining RV morphology and function in hypertensive patients than 2D-echocardiography, since 4D-echocardiography could estimate RV volumes and function without making geometric assumptions.
The purpose of this study was to identify clinical characteristics of type 2 diabetic patients with hypertension. The subjects were 209 type 2 diabetic patients who visited at the endocrine center at Kangnam St. Mary's Hospital of Catholic University in Seoul from beginning of March through the end of April in 2001. The patient's clinical laboratory data were assessed at medical record review. The data were analyzed using for t-test, $x^2$ test. The results were as follows: 1) There were no significant differences in age, body mass index, sex, family history of diabetes and oral hypoglycemic agents between hypertensive group and normotensive group, However, percentage of patients receiving insulin treatment was higher significantly in the hypertensive group. 2) Creatinine and microalbuminuria levels were higher significantly in the hypertensive group. However, fasting blood glucose levels were lower significantly in the hypertensive group. There were no significant differences in $HbA_1c$, 2-hour postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, lipoprotein(a) and blood urea nitrogen between two groups. Our present study supports that Creatinine and microalbuminuria levels were higher significantly in the hypertensive group.
This study was aimed at investigating the relationship of stress perception and psychopathology with biological variables such as systolic and diastolic blood pressure. serum total cholesterol high density lipoprotein and triglyceride in 50 adult patients with essential hypertension and 50 normotensive individuals. Both of the groups were matched to each other regarding age, sex, the level of education and BMI(body mass index). Stress perception and psychopathology between the two groups were compared using GARS and SCL-90-R scales. Biological variables such as blood pressure(systolic. diastolic), serum total cholesterol, high density lipoprotein and triglyceride were measured in all the subjects. The results were as follows ; 1) Hypertensive patients scored significantly higher than normotensive individuals in stress perception related to unusual happenings, change or no change in routine and overall global area, respectively. 2) Regarding psychopathology, hypertensive patients scored significantly higher than normotensive individuals in depression. hostility and interpersonal sensitivity. respectively. 3) Systolic blood pressure had a significantly positive correlation with scores of stress perception related to sickness and injury, and change or no change in routine, respectively. Diastolic blood pressure had a significantly positive correlation with scores of stress perception related to change or no change in routine. 4) In hypertensive patients. the level of serum total cholesterol had a significantly positive correlation with scores of stress perception related to unusual happenings. However, the level of serum triglyceride had a significantly negative correlation with scores of stress perception related to changes in relationships, sickness or injury, and change or no chang in routine. 5) There were no significant correlations between scores of stress perception and biological factors in the normotensive group. 6) The level of serum triglyceride correlated negatively with phobic anxiety in hypertensive group. whereas it correlated positively with PSDI in normotensive group. In conclusion, these results suggest that hypertensive patients have higher level of stress perception and psychopathology than normal individuals. In hypertensive patients, their stress perception is suggested to be correlated with serum cholesterol.
Background and Purpose: Sybsun-points are located at the tips of all fingers, 0.1chon from the finger nails, totaling 10 points on both hands. These points have been used for emergency care, fainting, epilepsy, cerebrovascular accidents, hypertension, unconsciousness, high fever etc. The most common technique is bleeding with a needle at these points. Hypertension and fever are the main factors for stroke patients’progress. We investigated whether venesection at Sybsun-points has effects on blood pressure and body temperature in stroke patients. Materials and Methods: 79 stroke patients were enrolled in this study from 1 Jan. 1999 to 30 Sep. 1999. All of them were admitted in Kyunghee University, Hospital of Oriental Medicine. Among them, 62 patients were hypertensive people, 17 were normal. Among the hypertensive patients, 27 were stage 1,20 were stage 2, 15 were stage 3 by classification of JNC 1997. All of the hypertensive patients had been taking drugs, while the normal group did not. From 2pm to 3pm, every 30 minutes we checked patients' blood pressure and body temperature by 24ABPM and tympanic thermometer. After 30 minutes passed, we phlebotomized patients Sybsun-points with Samneung needle 2-3cc of blood. Right after the bleeding, we checked blood pressure and body temperature. After the bleeding, for the next hour and a half, we checked each patient’s blood pressure and body temperature every thirty minutes, or a total of three times. We compared the blood pressure and the body temperature before and after treatment(p<0.05). Results: 1. Venesection at Sybsun-points significantly decreased systolic blood pressure on stage 3 hypertensive patients(p<0.0l). 2. Venesection at Sybsun-points significantly decreased diastolic blood pressure on stage 3 hypertensive patients(p<0.05) 3. Venesection at Sybsun-points had no effect on the change of body temperature. Conclusions: Though further study is needed, our findings suggest that Venesection at Sybsun-points may alleviate hypertension in stroke patients.
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