简介：Itisveryimportanttomaintainthelevelofmeanarterialpressure(MAP).TheMAPcontrolisappliedinmanyclinicalsituations,includinglimitingbleedingduringcardiacsurgeryandpromotinghealingforpatient'spost-surgery.Thispaperpresentsafuzzycontroller-basedmultiple-modeladaptivecontrolsystemforpostoperativebloodpressuremanagement.Multiple-modeladaptivecontrol(MMAC)algorithmisusedtoidentifythepatientmodel,anditisafeasiblesystemidentificationmethodeveninthepresenceoflargenoise.Fuzzycontrol(FC)methodisusedtodesigncontrollerbank.Eachfuzzycontrollerinthecontrollerbankisinfactanonlinearproportional-integral(PI)controller,whoseproportionalgainandintegralgainareadjustedcontinuouslyaccordingtoerrorandrateofchangeoferroroftheplantoutput,resultinginbetterdynamicandstablecontrolperformancethantheregularPIcontroller,especiallywhenanonlinearprocessisinvolved.Fordemonstration,anonlinear,pulsatile-flowpatientmodelisusedforsimulation,andtheresultsshowthattheadaptivecontrolsystemcaneffectivelyhandlethechangesinpatient'sdynamicsandprovidesatisfactoryperformanceinregulationofbloodpressureofhypertensionpatients.

简介：无

简介：AbstractObjective:This article aimed to compare the peripheral blood flow intensity (BFI) in the maternal right and left kidney in uncomplicated third trimester pregnancies and to study possible associations between parenchymal BFI in the kidneys and maternal, labor and new-born characteristics.Methods:We conducted a prospective cohort study in third trimester pregnancies at Trondheim University Hospital, Norway, from January to April 2018. The BFI in the maternal kidneys was examined with color Doppler ultrasound and the peripheral BFI was calculated using the Pixel Flux-method which is a method based on pixel wise calculation of color in an image. Velocity was coded by the color bar in the ultrasound device. The peripheral BFI was calculated as the product of velocity and area encoded by all colored pixels divided by all pixels within the cortical layer by a software examining the color in each pixel of a standardized region of interest of the renal parenchyma in video-clips through a complete heart cycle. BFI (cm/s) was thus calculated as follows:The primary outcome measure was peripheral BFI in the renal cortex. We also examined associations between BFI in the entire cortex with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight.Results:In all, 51 pregnant women were included in the study, but 17 were excluded, mainly due to movement artifacts from the pulsating aorta, leaving 34 women in the final study population. We found significantly lower BFI in the cortex of the left kidney compared with the right kidney, 0.37 cm/s versus 0.69 cm/s, respectively (P = 0.04). Dividing into regions, the BFI was significantly lower in the proximal 25% of the left renal cortex compared to the corresponding right side (P= 0.01), and in the proximal 50% cortex (P= 0.02), but the differences were not significantly different in the distal 25% (P= 0.06) or in the distal 50% (P= 0.20) of the renal cortex.We observed a significant negative correlation between peripheral BFI in the left kidney and both systolic blood pressure (r = -0.38; P= 0.03) and diastolic blood pressure (r= -0.36; P= 0.04), and no significant correlations between BFI with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight in the left kidney (P > 0.05). We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics (P > 0.05).Conclusion:The BFI in the left renal cortex was lower compared with the right renal cortex, and BFI in the left renal cortex was negatively correlated with blood pressure, but not significantly correlated with maternal age, body mass index or newborn characteristics. We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics.

简介：AbstractAmbulatory blood pressure monitoring (ABPM) has become indispensable in the current management of hypertension. ABPM is particularly useful in the accurate diagnosis of hypertension. Its diagnostic thresholds had been recently established based on hard clinical outcomes. Cross-classification of patients according to office and ambulatory blood pressure identifies white-coat, masked, and sustained hypertension. ABPM is also useful in cardiovascular (CV) risk assessment. It provides information on daytime and nighttime blood pressure and circadian rhythm, particularly nighttime blood pressure dipping. Nighttime blood pressure is predictive of CV risk independent of office and daytime blood pressure. Isolated nocturnal hypertension is a special form of masked hypertension, with normal daytime but elevated nocturnal blood pressure. It also helps in the evaluation of blood pressure fluctuation and variation, such as morning blood pressure surge and reading-to-reading blood pressure variability. ABPM may derive several other indexes, such as ambulatory blood pressure index and salt sensitivity index, which may be useful in CV evaluations.

简介：BackgroundCentralaorticsystolicbloodpressure(CASP)hasbeenshowntobeastrongerpredictoroftarget-organdamageandcardiovasculareventsthanbrachialsystolicbloodpressure(BSBP),buttherewasnodataaboutwhetherCASPcanpredictprolongedQRSdurationmorethanBSBP.WeexaminedtheassociationofCASPandBSBPwithQRSdurationinruralcommunityresidents.MethodsWeretrospectivelyanalyzed490ruralcommunityresidents.Standardresting12-leadECGandcentralaorticbloodpressure(CABP)weremeasurednoninvasivelyinallsubjectsatbaseline.TheQRSdurationwasequaltoormorethan120msbeingdefinedasprolongedQRSduration.ResultsTheprolongedQRSdurationgroupshowedhigherCASP(139.38±11.67vs.135.36±16.22,P=0.031)andBSBP(136.03±6.74vs.124.44±13.01,P<0.001)ascomparedwithcontrols.MultivariatelinearregressionanalysisshowedthatCASP,BSBPandheartratewereindependentlyaffectingQRSduration.LogisticregressionanalysesshowedthatCASP(OR1.057,95%CI:1.027,1.088,P<0.001)andBSBP(OR1.056,95%CI:1.027,1.086,P=0.032)wereindependentpredictorsofprolongedQRSdurationafteradjustmentforage,sex,bodymassindex,heartrate.CASPhadabetterpredictivevalueforprolongedQRSdurationthan(AUC:0.793vs.0.601,P<0.001)BSBP.ConclusionsOurfindingsdemonstratethatbothCASPandBSBParerisksforprolongedQRSduration,butCASPcanpredictprolongedQRSdurationbetterthanBSBP.

简介：无

简介：BackgroundStudieshaveshownthatmiRNA-155playedanimportantroleintheprocessofdevelopmentofhypertension.However,thereisnodateaboutmiRNA-155andbloodpressuremonitoringparameters.Therefore,weexaminedwhetherinhypertensivepatientstheexpressionlevelofplasmamiRNA-155relatedto24-hambulatorybloodpressuremonitoring(ABPM)parameters.MethodsAcohortofadultpatientsscheduledtoreceivephysicalexamination,officeandambulatorybloodpressuremonitoring.Quantitativereversetranscriptasepolymerasechainreaction(qRT-PCR)wasusedtoevaluatetheexpressionofselectedmiRNA-155.ThemiRNA-155expressionlevelcorrelationbetweenbloodpressureparameterswasassessedusingtheSpearmancorrelationcoefficient.ResultsFiftyfouressentialhypertensionpatients(25men;meanage,53.28±9.52years)andthirtyhealthyvolunteers(15men;meanage,53.03±5.87years)wereincluded.WeobservedhigherexpressionlevelofmiRNA-155(32.31±2.85vs27.21±1.59,P<0.001)inhypertensivepatientscomparedtohealthycontrolindividuals.MiRNA-155expressionlevelshowedsignificantpositivecorrelationwith24hDaytimeSBP(r=0.681,P<0.001),24hDaytimeDBP(r=0.473,P<0.001),24hDaytimePP(r=0.565,P<0.001)anddipping(r=0.257,P=0.018),respectively.ConclusionsOurstudyshowedthatmiRNA-155expressionlevelwasassociatedpositivelywithdaytimebloodpressuremonitoringparameters,aswellasbloodpressurevariability,indicatingapossibleimplicationofmiRNA-155inthepathogenesisofhypertension.

简介：

简介：ＳＴＵＤＹＯＦＡＤＩＶＩＣＥＯＮＴＨＥＷＡＴＣＨＦＯＲＰＡＲＡＭＥＴＥＲＯＦＢＬＯＯＤＰＲＥＳＳＵＲＥＡＮＤＩＴＳＦＬＯＷＢＹＵＮＤＡＭＡＧＥＤＭＥＴＨＯＤＳＴＵＤＹＯＦＡＤＩＶＩＣＥＯＮＴＨＥＷＡＴＣＨＦＯＲＰＡＲＡＭＥＴＥＲＯＦＢＬＯＯＤＰＲＥＳ...

简介：

简介：

简介：AIMTo评估变化在phacoemulsification(PC)和femtosecond激光(FSL)期间帮助了的血压(BP)奔流surgery.METHODSA回顾的图表评论为从2013年7月收到了传统的phacoemulsification外科(PC组)和帮助FSL的奔流外科(FS组)到2014年12月的所有病人被执行。完全，从收到过程的二种类型的133个病人的206只眼睛被包括。耐心的特征(年龄，性，和高血压历史)，外科手术前、手术后的位／秒是收缩的collected.RESULTSThe支持operative，心脏舒张的位／秒(公里Hg)是124.89摥琠?桴?楳楬潣敮瀠畬？

简介：AbstractBackground:The association between dietary sodium intake and blood pressure variability (BPV) in hypertensive patients remains unclear. The objective of this study was to demonstrate whether dietary sodium intake is a predictor of elevated BPV in Chinese patients with hypertension.Methods:A total of 235 patients with essential hypertension were enrolled in the Department of Cardiology, Chinese People’s Liberation Army (PLA) General Hospital in 2018 to 2019, all of whom underwent 24-h ambulatory blood pressure monitoring. BPV was calculated as the standard deviation (SD), coefficient of variation (CV), variation independent of mean (VIM) of blood pressure measurements, respectively, and divided into diurnal systolic BPV (SBPV), diurnal diastolic BPV (DBPV), nocturnal SBPV, and nocturnal DBPV. 24-h urine samples were collected to measure 24-h urine sodium excretion, which represents dietary sodium intake. The relationship between dietary sodium intake and BPV was analyzed by using Spearman correlations and multiple linear regression analysis.Results:Nocturnal SBPV-SD, CV, VIM, and nocturnal DBPV-SD in the high urine sodium excretion group were significantly higher than those in the medium and low urine sodium excretion groups, whereas diurnal SBPV-SD, CV, VIM, diurnal DBPV-SD, CV, VIM, and nocturnal DBPV-CV, VIM were not. Using the Spearman correlation analysis, we found a linear correlation between 24-h urine sodium excretion and nocturnal SBPV-SD, CV, VIM (SD, r= 0.22, P= 0.001; CV, r= 0.17, P= 0.009; VIM, r= 0.16, P = 0.020), nocturnal DBPV-SD (r = 0.21, P = 0.001), respectively. After further adjusting for confounding factors by multiple linear regression, the positive correlations remained between 24-h urine sodium excretion and nocturnal SBPV-SD, CV, VIM (SD, β= 0.224, P < 0.001; CV, β= 0.211, P= 0.001; VIM, β= 0.213, P= 0.001), nocturnal DBPV (SD, β= 0.215, P= 0.001), respectively.Conclusions:Dietary sodium intake is associated with nocturnal SBPV in Chinese patients with hypertension.

简介：

简介：Inordertoanalyzetheexperimentalcardiovascularsignalwithhighaccuracy,asystem,integratingreal-timemonitoringandoff-linefurtheranalysis,wasdevelopedandverified.Thedesign,dataprocessingandanalysismethodsaswellastestingresultsaredescribed.With5samplingfrequencychoicesand8channeldataacquisition,thesystemachievedhighperformancesinbeat-to-beatmonitoring,signalprocessingandanalysis.Testswerecarriedouttovalidateitsperformanceinreal-timemonitoring,effectivenessofdigitalfilters,QRSandbloodpressuredetectionreliability,andRR-intervaltimingaccuracy.TheQRSdetectionratewasatleast99.46%fortherecordswithfewnoisesfromMIT-BIHarrhythmiadatabaseusingthealgorithmforreal-timemonitoring,andnolessthan96.43%fortherecordswithsomenoises.Intheconditionthatnoiseamplitudelevelswerelessthan80%,thestandarddeviationsforRR-intervaltimingwerelessthan1mswithageneratedECGcorruptedwithvariousnoisesfromMIT-BmNoiseStressTestDatabase.Besides,thesystemisopenforfunctionexpansiontomeetfurtherstudyspecificneeds.

简介：Thepaperstudiestheproblemoffluidflowandfluidshearstressincanaliculiwhentheosteonissubjecttoexternalmechanicalloadingandbloodpressureoscillation.Thesingleosteonismodeledasasaturatedporoelasticcylinder.Solidskeletonisregardedasaporoelastictransverselyisotropicmaterial.Togetnear-realisticresults,boththeinterstitialfluidandthesolidmatrixareregardedascompressible.BloodpressureoscillationintheHaveriancanalisconsidered.Usingtheporoelasticitytheory,ananalyticalsolutionoftheporefluidpressureisobtained.Assumingthefluidincanaliculiisincompressible,analyticalsolutionsoffluidflowvelocityandfluidshearstresswiththeNavier-Stokesequationsofincompressiblefluidareobtained.Theeffectofvariousparametersonthefluidflowvelocityandfluidshearstressisstudied.更多还原

简介：AbstractBackground:Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.Methods:This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.Results:Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR= 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.Conclusions:In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

简介：BackgroundTherewerefewstudiestoexploretherelationshipbetweenpostoperativemeansystolicbloodpressure(PMSBP)within6haftercardiaccatheterizationandcontrast-inducednephropathy(CIN).MethodsFromJune2010toFebruary2013,299consecutivepatientsundergoingcardiaccatheterizationwererecruited.PatientswereclassifiedintoquartilesbasedonPMSBP(<112,112-120,121-131,and>132mmHg).Baselinedata,CINincidenceandin-hospitaloutcomeswerecomparedbetweenthegroups.LogisticregressionwasusedtoassesstherelationshipbetweenPMSBPandCIN.ResultsCINoccurredin26(8.7%)patients.TheincidenceofCINinPMSBPquartileswere15.3%(11/72),15.1%(11/73),2.4%(2/82)and2.8%(2/72)(P=0.001)respectively.Therewerenosignificantdifferenceinin-hospitaldeath,renalreplacementtherapyandintra-aorticballoonpump(IABP)supportbetweenthegroups(P>0.05).UnivariatelogisticregressionanalysisshowedthatPMSBPwassignificantlyassociatedwithCIN(OR=0.956,95%CI:0.928-0.986,P=0.004).Multivariatelogisticregressionanalysisfoundthatafteradjustingbaselineestimateglomerularfiltrationrate,age>75yearsandacutemyocardialinfarction,PMSBP<120mmHgwasstillanindependentriskfactorforCIN(OR=5.049,95%CI:1.820-14.009,P=0.002).ConclusionsLowerPMSBPwassignificantlyassociatedwithanincreasedriskofCIN.PMSBP<120mmHgwasanindependentriskfactorforCIN.Intensiveblood-pressurecontrolaftercardiaccatheterizationmightincreasetheriskofCIN.

简介：AbstractBackground:Generic drugs are bioequivalent to their brand-name counterparts; however, concerns still exist regarding the effectiveness and safety of generic drugs because of small sample sizes and short follow-up time in most studies. The purpose of this study was to evaluate the long-term antihypertensive efficacy, cost-effectiveness and cardiovascular outcomes of generic drugs compared with brand-name drugs.Methods:In a multicenter, community-based study including 7955 hypertensive patients who were prospectively followed up for an average of 2.5 years, we used the propensity-score-matching method to match the patients using brand-name drugs to those using generic drugs in a ratio of 1:2, 2176 patients using brand-name drugs and 4352 patients using generic drugs.Results:There were no significant differences between generic drugs and brand-name drugs in blood pressure (BP)-lowering efficacy, BP control rate, and cardiovascular outcomes including coronary heart disease and stroke. The adjusted mean (95% confidence interval [CI]) of systolic BP (SBP)-lowering was -7.9 mmHg (95% CI, -9.9 to -5.9) in the brand-name drug group and -7.1 mmHg (95% CI, -9.1 to -5.1) in the generic drug group after adjusting for age, sex, body mass index, number of antihypertensive drugs and traditionally cardiovascular risk factors. Among patients aged <60 years, brand-name drugs had a higher BP control rate (47% vs. 41%; P = 0.02) and a greater effect in lowering SBP compared with generic drugs, with the between-group difference of 1.5 mmHg (95% CI, 0.2-2.8; P = 0.03). BP control rate was higher in male patients using brand-name drugs compared with those using generic drugs (46% vs. 40%; P = 0.01). Generic drugs treatment yielded an average annual incremental cost-effectiveness ratio of $315.4 per patient per mmHg decrease in SBP compared with brand-name drugs treatment.Conclusions:Our data suggested that generic drugs are suitable and cost-effective in improving hypertension management and facilitating public health benefits, especially in low- and middle-income areas.

简介：无